{"hospital_name":"CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER","last_updated_on":"2026-02-28","version":"3.0.0","location_name": ["CHI St. Luke's Health - Baylor St. Luke's Medical Center","CHI St. Luke's Health - Baylor St. Luke's Medical Center ER","Baylor St. Luke's Medical Center - McNair Campus"],"hospital_address": ["1101 Bates Avenue, Houston, TX 77030","6720 Bertner Ave, Houston, TX 77030","7200 Cambridge St, Houston, TX 77030"],"license_information":{"license_number":"118","state":"TX"},"type_2_npi": ["1184622847","1285678458"],"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":"Bradley Lembcke MD, Hospital President"},"standard_charge_information":[{"description":"HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC","code_information":[{"code":"001","type":"MS-DRG"}],"standard_charges":[{"minimum":106452,"maximum":715521.11,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":339046.93,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_percentage":57,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":71,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":175410,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":351505,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":106452,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":390562,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":221162,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":190000,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":319318,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":420356,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":663392,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":381483,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":330240.51,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":330240.51,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":308224.48,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":330240.51,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":228163,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":335203,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":335203,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":353766,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_percentage":56,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":297216.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":715521.11,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":520494,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":520494,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":158515.45,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":330240.51,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":195055,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":379004,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":281458,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":421060,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":421060,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":330240.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":224563.55,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":220160.34,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":226765.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":220160.34,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":220160.34,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":222361.95,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":235571.57,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":220160.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":220160.34,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":213005.13,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":264192.41,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":235571.57,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":231168.36,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":224563.55,"methodology":"case rate"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0011","type":"APR-DRG"}],"standard_charges":[{"minimum":32056,"maximum":118607.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":33658.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":36864.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":88474.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":32056,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":76934.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":32056,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":32697.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":32697.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":118607.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":32697.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":78537.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":118607.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":33017.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":33017.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":79178.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":33017.68,"methodology":"case rate"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0012","type":"APR-DRG"}],"standard_charges":[{"minimum":33307,"maximum":123235.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":34972.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38303.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":91927.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":33307,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":79936.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":33307,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":33973.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":33973.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":123235.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":33973.14,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":81602.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":123235.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":34306.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":34306.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":82268.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":34306.21,"methodology":"case rate"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0013","type":"APR-DRG"}],"standard_charges":[{"minimum":43363,"maximum":160443.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":45531.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":49867.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":119681.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":43363,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":104071.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":43363,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":44230.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":44230.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":160443.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44230.26,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":106239.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":160443.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44663.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":44663.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":107106.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":44663.89,"methodology":"case rate"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0014","type":"APR-DRG"}],"standard_charges":[{"minimum":84163,"maximum":311403.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":88371.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":96787.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":232289.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":84163,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201991.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":84163,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":85846.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":85846.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":311403.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":85846.26,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206199.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":311403.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":86687.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":86687.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":207882.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":86687.89,"methodology":"case rate"}]}]},{"description":"HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC","code_information":[{"code":"002","type":"MS-DRG"}],"standard_charges":[{"minimum":62646.46,"maximum":390562,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":133993.82,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_percentage":57,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":71,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":175410,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":351505,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":106452,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":390562,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":221162,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":190000,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":152852,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":164447,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":259525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":149240,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":130513.46,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":130513.46,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":121812.56,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":130513.46,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":89260,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":131134,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":131134,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":138396,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_percentage":56,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":117462.11,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":282779.16,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":203622,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":203622,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":62646.46,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":130513.46,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":88133,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":148270,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":110109,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":164722,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":164722,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":130513.46,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":88749.15,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":87008.97,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":89619.24,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":87008.97,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":87008.97,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":87879.06,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":93099.6,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":87008.97,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":87008.97,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":84181.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":104410.77,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":93099.6,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":91359.42,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":88749.15,"methodology":"case rate"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0021","type":"APR-DRG"}],"standard_charges":[{"minimum":36008,"maximum":133229.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":37808.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":41409.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":99382.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":36008,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":86419.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":36008,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":36728.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":36728.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":133229.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":36728.16,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":88219.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":133229.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":37088.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":37088.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":88939.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":37088.24,"methodology":"case rate"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0022","type":"APR-DRG"}],"standard_charges":[{"minimum":46487,"maximum":172001.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":48811.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":53460.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":128304.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":46487,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":111568.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":46487,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":47416.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":47416.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":172001.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":47416.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":113893.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":172001.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":47881.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":47881.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":114822.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":47881.61,"methodology":"case rate"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0023","type":"APR-DRG"}],"standard_charges":[{"minimum":57868,"maximum":214111.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":60761.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":66548.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":159715.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":57868,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":138883.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":57868,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":59025.36,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":59025.36,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":214111.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":59025.36,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":141776.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":214111.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":59604.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":59604.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":142933.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":59604.04,"methodology":"case rate"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0024","type":"APR-DRG"}],"standard_charges":[{"minimum":234950,"maximum":869315,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":246697.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":270192.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":648462,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":234950,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":563880,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":234950,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":239649,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":239649,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":869315,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":239649,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":575627.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":869315,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":241998.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":241998.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":580326.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":241998.5,"methodology":"case rate"}]}]},{"description":"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE MOUTH AND NECK WITH MAJOR O.R. PROCEDURES","code_information":[{"code":"003","type":"MS-DRG"}],"standard_charges":[{"minimum":120854.04,"maximum":545521.67,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":258493.35,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":160729,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":253858,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":282065,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":229590,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":319824,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":504736,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":290248,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":251779.23,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":251779.23,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":234993.95,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":251779.23,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":173596,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":255036,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":255036,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":269159,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_percentage":56,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":226601.31,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":545521.67,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":396013,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":396013,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":120854.04,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":251779.23,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":153463,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":288362,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":214145,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":320360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":320360,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":251779.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":171209.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":167852.82,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":172888.41,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":167852.82,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":167852.82,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":169531.35,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":179602.52,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":167852.82,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":167852.82,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":162397.61,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":201423.39,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":179602.52,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":176245.47,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":171209.88,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES","code_information":[{"code":"004","type":"MS-DRG"}],"standard_charges":[{"minimum":80034.55,"maximum":361267.05,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":171185,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":101513,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":160332,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":178145,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":155786,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":210862,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":332776,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":191363,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":166738.64,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":166738.64,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":155622.73,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":166738.64,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":114453,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":168147,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":168147,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":177459,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_percentage":56,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":150064.78,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":361267.05,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":261094,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":261094,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":80034.55,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":166738.64,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":105810,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":190119,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":141187,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":211215,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":211215,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":166738.64,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":113382.28,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":111159.09,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":114493.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":111159.09,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":111159.09,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":112270.69,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":118940.23,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":111159.09,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":111159.09,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":107546.42,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":133390.91,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":118940.23,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":116717.05,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":113382.28,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0041","type":"APR-DRG"}],"standard_charges":[{"minimum":33553,"maximum":124146.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":35230.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38585.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":92606.28,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":33553,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":80527.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":33553,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":34224.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":34224.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":124146.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":34224.06,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":82204.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":124146.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":34559.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":34559.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":82875.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":34559.59,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0042","type":"APR-DRG"}],"standard_charges":[{"minimum":40888,"maximum":151285.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":42932.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":47021.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":112850.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":40888,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":98131.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":40888,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":41705.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":41705.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":151285.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":41705.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":100175.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":151285.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":42114.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":42114.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":100993.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":42114.64,"methodology":"case rate"}]}]},{"description":"HC CT CEREBRAL PERFUSION ANS","code_information":[{"code":"0042T","type":"CPT"},{"code":"0350","type":"RC"}],"standard_charges":[{"minimum":157.95,"maximum":351,"gross_charge":351,"discounted_cash":122.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":245.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":228.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":228.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":245.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":228.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":245.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":351,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":263.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":175.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":298.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":193.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":193.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":157.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":193.05,"methodology":"fee schedule"}]}]},{"description":"HC CT CEREBRAL PERFUSION ANS","code_information":[{"code":"0042T","type":"CPT"},{"code":"0350","type":"RC"}],"standard_charges":[{"minimum":94.77,"maximum":1891,"gross_charge":351,"discounted_cash":122.85,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":665,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":552,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":761,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":590,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":126.42,"standard_charge_algorithm": "Lesser of $126.42 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":309.68,"standard_charge_algorithm": "Lesser of $309.68 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":117.6,"standard_charge_algorithm": "Lesser of $117.60 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":343,"standard_charge_algorithm": "Lesser of $343.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":262.64,"standard_charge_algorithm": "Lesser of $262.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":210.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":245.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":228.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":228.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":900,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":245.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":800,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":800,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":228.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":245.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1154.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":351,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":263.25,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":157.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":298.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1703,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1264,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":1891,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":164.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":1891,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":193.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":193.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":127,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":290,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":143.91,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":193.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":94.77,"methodology":"fee schedule"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0043","type":"APR-DRG"}],"standard_charges":[{"minimum":62536,"maximum":231383.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":65662.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":71916.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":172599.36,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":62536,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":150086.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":62536,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":63786.72,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":63786.72,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":231383.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":63786.72,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":153213.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":231383.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":64412.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":64412.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":154463.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":64412.08,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0044","type":"APR-DRG"}],"standard_charges":[{"minimum":97264,"maximum":359876.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":102127.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":111853.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":268448.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":97264,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":233433.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":97264,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":99209.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":99209.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":359876.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":99209.28,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":238296.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":359876.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":100181.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":100181.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":240242.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":100181.92,"methodology":"case rate"}]}]},{"description":"LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT","code_information":[{"code":"005","type":"MS-DRG"}],"standard_charges":[{"minimum":60576.31,"maximum":273434.72,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":129566,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":101334,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":169259,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":75636,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":188065,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":129611,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":135000,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":129412,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":158921,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":250804,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":144225,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126200.64,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":126200.64,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":117787.27,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":126200.64,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":86260,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":126728,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":126728,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":133746,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":113580.58,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":273434.72,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":196780,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":196780,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":60576.31,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":126200.64,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":74499,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":143288,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":106409,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":159187,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":159187,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":126200.64,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":85816.44,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":84133.76,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":86657.78,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":84133.76,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":84133.76,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":84975.1,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":90023.13,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":84133.76,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":84133.76,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":81399.42,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":100960.52,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":90023.13,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":88340.45,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":85816.44,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0051","type":"APR-DRG"}],"standard_charges":[{"minimum":33617,"maximum":124382.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":35297.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38659.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":92782.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":33617,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":80680.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":33617,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":34289.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":34289.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":124382.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":34289.34,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":82361.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":124382.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":34625.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":34625.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":83033.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":34625.51,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0052","type":"APR-DRG"}],"standard_charges":[{"minimum":41153,"maximum":152266.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":43210.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":47325.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":113582.28,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":41153,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":98767.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":41153,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":41976.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":41976.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":152266.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":41976.06,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":100824.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":152266.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":42387.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":42387.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":101647.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":42387.59,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0053","type":"APR-DRG"}],"standard_charges":[{"minimum":45064,"maximum":166736.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":47317.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":51823.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":124376.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":45064,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":108153.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":45064,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":45965.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":45965.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":166736.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":45965.28,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":110406.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":166736.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":46415.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":46415.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":111308.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":46415.92,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0054","type":"APR-DRG"}],"standard_charges":[{"minimum":62557,"maximum":231460.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":65684.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":71940.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":172657.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":62557,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":150136.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":62557,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":63808.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":63808.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":231460.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":63808.14,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":153264.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":231460.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":64433.71,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":64433.71,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":154515.79,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":64433.71,"methodology":"case rate"}]}]},{"description":"LIVER TRANSPLANT WITHOUT MCC","code_information":[{"code":"006","type":"MS-DRG"}],"standard_charges":[{"minimum":28150.38,"maximum":188065,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":60210.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":101334,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":169259,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":75636,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":188065,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":129611,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":135000,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":54562,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":72365,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":114204,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":65673,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":58646.61,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":58646.61,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":54736.84,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":58646.61,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":39279,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":57705,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":57705,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":60901,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":52781.95,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":127067.66,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":89604,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":89604,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":28150.38,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":58646.61,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":34816,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":65246,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":48453,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":72486,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":72486,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":58646.61,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":39879.7,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":39097.74,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":40270.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":39097.74,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":39097.74,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":39488.72,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":41834.59,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":39097.74,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":39097.74,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":37827.07,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":46917.29,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":41834.59,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":41052.63,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":39879.7,"methodology":"case rate"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0061","type":"APR-DRG"}],"standard_charges":[{"minimum":44451,"maximum":164468.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":46673.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":51118.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":122684.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44451,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":106682.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":44451,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":45340.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":45340.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":164468.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":45340.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":108904.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":164468.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":45784.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":45784.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":109793.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":45784.53,"methodology":"case rate"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0062","type":"APR-DRG"}],"standard_charges":[{"minimum":45033,"maximum":166622.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":47284.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":51787.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":124291.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":45033,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":108079.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":45033,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":45933.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":45933.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":166622.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":45933.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":110330.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":166622.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":46383.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":46383.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":111231.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":46383.99,"methodology":"case rate"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0063","type":"APR-DRG"}],"standard_charges":[{"minimum":49788,"maximum":184215.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":52277.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":57256.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":137414.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":49788,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":119491.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":49788,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":50783.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":50783.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":184215.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":50783.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":121980.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":184215.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":51281.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":51281.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":122976.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":51281.64,"methodology":"case rate"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0064","type":"APR-DRG"}],"standard_charges":[{"minimum":77043,"maximum":285059.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":80895.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":88599.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":212638.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":77043,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":184903.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":77043,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":78583.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78583.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":285059.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78583.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":188755.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":285059.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":79354.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":79354.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":190296.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":79354.29,"methodology":"case rate"}]}]},{"description":"LUNG TRANSPLANT","code_information":[{"code":"007","type":"MS-DRG"}],"standard_charges":[{"minimum":64943,"maximum":334487.86,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":158495.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":102445,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":201953,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":64943,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":224392,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":154647,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":138492,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":195026,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":307783,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":176991,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":154379.01,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":154379.01,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":144087.08,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":154379.01,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":105857,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":155519,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":155519,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":164131,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":138941.11,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":334487.86,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":241485,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":241485,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":74101.93,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":154379.01,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":88293,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":175841,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":130583,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":195352,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":195352,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":154379.01,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":104977.73,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":102919.34,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":106006.93,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":102919.34,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":102919.34,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":103948.54,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":110123.7,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":102919.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":102919.34,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":99574.47,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":123503.21,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":110123.7,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":108065.31,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":104977.73,"methodology":"case rate"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0071","type":"APR-DRG"}],"standard_charges":[{"minimum":43682,"maximum":161623.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":45866.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":50234.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":120562.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":43682,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":104836.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":43682,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":44555.64,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":44555.64,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":161623.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44555.64,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":107020.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":161623.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44992.46,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":44992.46,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":107894.54,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":44992.46,"methodology":"case rate"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0072","type":"APR-DRG"}],"standard_charges":[{"minimum":66524,"maximum":246138.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":69850.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":76502.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":183606.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":66524,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":159657.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":66524,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":67854.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":67854.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":246138.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":67854.48,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":162983.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":246138.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":68519.72,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":68519.72,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":164314.28,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":68519.72,"methodology":"case rate"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0073","type":"APR-DRG"}],"standard_charges":[{"minimum":99010,"maximum":366337,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":103960.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":113861.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":273267.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":99010,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":237624,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":99010,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":100990.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":100990.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":366337,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":100990.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":242574.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":366337,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":101980.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":101980.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":244554.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":101980.3,"methodology":"case rate"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0074","type":"APR-DRG"}],"standard_charges":[{"minimum":280592,"maximum":1038190.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":294621.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":322680.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":774433.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":280592,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":673420.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":280592,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":286203.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":286203.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1038190.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":286203.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":687450.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1038190.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":289009.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":289009.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":693062.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":289009.76,"methodology":"case rate"}]}]},{"description":"HC PLACE STENT/CHEST VRT ART","code_information":[{"code":"0075T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":8082,"maximum":17960,"gross_charge":17960,"discounted_cash":6286,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12572,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11674,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11674,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12572,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11674,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12572,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":17960,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":13470,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":8980,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":15266,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9878,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9878,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":8082,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9878,"methodology":"fee schedule"}]}]},{"description":"HC PLACE STENT/CHEST VRT ART","code_information":[{"code":"0075T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":724.3,"maximum":17960,"gross_charge":17960,"discounted_cash":6286,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":12572,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":13649.6,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1167.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2324.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":994.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":2475.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":724.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":3528.74,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":10776,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12572,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11674,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11674,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12572,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11674,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12572,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":17960,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":13470,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8082,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":15266,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":8441.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9878,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9878,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":6497.93,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14838.56,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":7363.6,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1975.6,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2647.31,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1975.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9878,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6163.88,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2015.12,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2706.58,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6163.88,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":4849.2,"methodology":"fee schedule"}]}]},{"description":"SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT","code_information":[{"code":"008","type":"MS-DRG"}],"standard_charges":[{"minimum":31459.39,"maximum":185546,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":67288.13,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":124164,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":166991,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":64632,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":185546,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":127876,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":63431,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":81198,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":128143,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":73689,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65540.39,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":65540.39,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":61171.03,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":65540.39,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":44073,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":64749,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":64749,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":68335,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":58986.35,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":142004.17,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":100541,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":100541,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":31459.39,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":65540.39,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":37874,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":73210,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":54367,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":81334,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":81334,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":65540.39,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":44567.47,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":43693.59,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":45004.4,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":43693.59,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":43693.59,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":44130.53,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":46752.15,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":43693.59,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":43693.59,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":42273.55,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":52432.31,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":46752.15,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":45878.27,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":44567.47,"methodology":"case rate"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0081","type":"APR-DRG"}],"standard_charges":[{"minimum":24703,"maximum":91401.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":25938.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":28408.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":68180.28,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24703,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":59287.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":24703,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25197.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25197.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":91401.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25197.06,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":60522.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":91401.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25444.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":25444.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":61016.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25444.09,"methodology":"case rate"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0082","type":"APR-DRG"}],"standard_charges":[{"minimum":29495,"maximum":109131.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":30969.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":33919.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":81406.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":29495,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":70788,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":29495,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":30084.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":30084.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":109131.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":30084.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":72262.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":109131.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":30379.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":30379.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":72852.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":30379.85,"methodology":"case rate"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0083","type":"APR-DRG"}],"standard_charges":[{"minimum":56660,"maximum":209642,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":59493,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":65159,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":156381.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":56660,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":135984,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":56660,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":57793.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":57793.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":209642,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":57793.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":138817,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":209642,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":58359.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":58359.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":139950.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":58359.8,"methodology":"case rate"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0084","type":"APR-DRG"}],"standard_charges":[{"minimum":83826,"maximum":310156.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":88017.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":96399.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231359.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":83826,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201182.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":83826,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":85502.52,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":85502.52,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":310156.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":85502.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":205373.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":310156.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":86340.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":86340.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":207050.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":86340.78,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"009","type":"MS-DRG"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0091","type":"APR-DRG"}],"standard_charges":[{"minimum":52049,"maximum":192581.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":54651.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":59856.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":143655.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":52049,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":124917.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":52049,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":53089.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":53089.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":192581.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":53089.98,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":127520.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":192581.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":53610.47,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":53610.47,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":128561.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":53610.47,"methodology":"case rate"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0092","type":"APR-DRG"}],"standard_charges":[{"minimum":53670,"maximum":198579,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":56353.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":61720.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":148129.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":53670,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":128808,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":53670,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":54743.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":54743.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":198579,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":54743.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":131491.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":198579,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":55280.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":55280.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":132564.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":55280.1,"methodology":"case rate"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0093","type":"APR-DRG"}],"standard_charges":[{"minimum":81603,"maximum":301931.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":85683.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":93843.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":225224.28,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":81603,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":195847.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":81603,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":83235.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":83235.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":301931.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":83235.06,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":199927.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":301931.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":84051.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":84051.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201559.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":84051.09,"methodology":"case rate"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0094","type":"APR-DRG"}],"standard_charges":[{"minimum":166096,"maximum":614555.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":174400.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":191010.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":458424.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":166096,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":398630.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":166096,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":169417.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":169417.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":614555.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":169417.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":406935.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":614555.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":171078.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":171078.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":410257.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":171078.88,"methodology":"case rate"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"010","type":"MS-DRG"}],"standard_charges":[{"minimum":34648,"maximum":205896.21,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":97563.13,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":93570,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":125847,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":48707,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":139830,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":98339,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":47045,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":118981,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":187772,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":107978,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":95029.02,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":95029.02,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":88693.76,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":95029.02,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":64581,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":94879,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":94879,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":100133,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":85526.12,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":205896.21,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":147325,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":147325,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":45613.93,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":95029.02,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":34648,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":107277,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":79666,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":119180,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":119180,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":95029.02,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":64619.74,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":63352.68,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":65253.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":63352.68,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":63352.68,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":63986.21,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":67787.37,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":63352.68,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":63352.68,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":61293.72,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":76023.22,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":67787.37,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":66520.32,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":64619.74,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY FOR FACE MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC","code_information":[{"code":"011","type":"MS-DRG"}],"standard_charges":[{"minimum":31206.7,"maximum":140863.55,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":66747.66,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":58599,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":80523,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":127079,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":73077,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65013.95,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":65013.95,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":60679.69,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":65013.95,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":43707,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":64211,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":64211,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":67767,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":58512.56,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":140863.55,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":99705,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":99705,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":31206.7,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":65013.95,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":37115,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":72602,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":53916,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":80658,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":80658,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":65013.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":44209.49,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":43342.63,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":44642.91,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":43342.63,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":43342.63,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":43776.06,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":46376.62,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":43342.63,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":43342.63,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":41934,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":52011.16,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":46376.62,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":45509.77,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":44209.49,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY FOR FACE MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC","code_information":[{"code":"012","type":"MS-DRG"}],"standard_charges":[{"minimum":23982.67,"maximum":108255.1,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":51296.27,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":44353,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":61240,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":96646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":55576,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49963.89,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":49963.89,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":46632.97,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":49963.89,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":33240,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":48834,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":48834,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":51538,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":44967.51,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":108255.1,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":75828,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":75828,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":23982.67,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":49963.89,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":28827,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":55215,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":41004,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":61342,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":61342,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":49963.89,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":33975.45,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":33309.26,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":34308.54,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":33309.26,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":33309.26,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":33642.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":35640.91,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":33309.26,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":33309.26,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":32226.71,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":39971.12,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":35640.91,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":34974.73,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":33975.45,"methodology":"case rate"}]}]},{"description":"TRACHEOSTOMY FOR FACE MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC","code_information":[{"code":"013","type":"MS-DRG"}],"standard_charges":[{"minimum":15855.79,"maximum":71571.24,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":33913.76,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":32087,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":39546,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":62410,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":35889,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33032.88,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":33032.88,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":30830.69,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":33032.88,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":21465,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":31535,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":31535,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":33281,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":29729.6,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":71571.24,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":48967,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":48967,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":15855.79,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":33032.88,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":19332,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":35656,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":26479,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":39612,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":39612,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":33032.88,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":22462.36,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":22021.92,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":22682.58,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":22021.92,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":22021.92,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":22242.14,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":23563.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":22021.92,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":22021.92,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":21306.21,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":26426.31,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":23563.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":23123.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":22462.36,"methodology":"case rate"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"014","type":"MS-DRG"}],"standard_charges":[{"minimum":74286.42,"maximum":335320.61,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":158890.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_percentage":29,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_percentage":44,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_percentage":26,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_percentage":37,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":126985,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":195518,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":308560,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":177438,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":154763.36,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":154763.36,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":144445.8,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":154763.36,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":106125,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":155911,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":155911,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":164546,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":139287.02,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":335320.61,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":242095,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":242095,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":74286.42,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":154763.36,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":82495,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":176285,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":130913,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":195846,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":195846,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":154763.36,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":105239.09,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":103175.57,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":106270.84,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":103175.57,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":103175.57,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":104207.33,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":110397.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":103175.57,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":103175.57,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":99822.37,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":123810.69,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":110397.86,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":108334.35,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":105239.09,"methodology":"case rate"}]}]},{"description":"HC LAB KARIUS TEST","code_information":[{"code":"0152U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":2472.3,"maximum":5494,"gross_charge":5494,"discounted_cash":1922.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3845.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3571.1,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3571.1,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3845.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3571.1,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3845.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5494,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4120.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2747,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4669.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3021.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3021.7,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2472.3,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3021.7,"methodology":"fee schedule"}]}]},{"description":"HC LAB KARIUS TEST","code_information":[{"code":"0152U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":24.55,"maximum":6910.15,"gross_charge":5494,"discounted_cash":1922.9,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":3274.35,"standard_charge_algorithm": "Lesser of $3274.35 or 154 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":3845.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":28.44,"standard_charge_algorithm": "Lesser of $28.44 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":81.64,"standard_charge_algorithm": "Lesser of $81.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":24.55,"standard_charge_algorithm": "Lesser of $24.55 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":78.57,"standard_charge_algorithm": "Lesser of $78.57 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":59.13,"standard_charge_algorithm": "Lesser of $59.13 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3508.23,"standard_charge_algorithm": "Lesser of $3508.23 or 165 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3296.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3538,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":4837.11,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3206.31,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3845.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3189.3,"standard_charge_algorithm": "Lesser of $3189.30 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":3189.3,"standard_charge_algorithm": "Lesser of $3189.30 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3571.1,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2976.68,"standard_charge_algorithm": "Lesser of $2976.68 or 140 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3571.1,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":3189.3,"standard_charge_algorithm": "Lesser of $3189.30 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3845.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3571.1,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3845.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2870.37,"standard_charge_algorithm": "Lesser of $2870.37 or 135 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5494,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4120.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":6910.15,"standard_charge_algorithm": "Lesser of $6910.15 or 325 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1530.86,"standard_charge_algorithm": "Lesser of $1530.86 or 72 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3189.3,"standard_charge_algorithm": "Lesser of $3189.30 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2472.3,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4669.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":3189.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3189.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":3189.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2582.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":3189.3,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":3189.3,"standard_charge_algorithm": "Lesser of $3189.30 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3021.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3021.7,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1987.73,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4539.15,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2252.54,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3021.7,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2168.72,"standard_charge_algorithm": "Lesser of $2168.72 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2126.2,"standard_charge_algorithm": "Lesser of $2126.20 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2189.99,"standard_charge_algorithm": "Lesser of $2189.99 or 103 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2126.2,"standard_charge_algorithm": "Lesser of $2126.20 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2126.2,"standard_charge_algorithm": "Lesser of $2126.20 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2147.46,"standard_charge_algorithm": "Lesser of $2147.46 or 101 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":2275.03,"standard_charge_algorithm": "Lesser of $2275.03 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2126.2,"standard_charge_algorithm": "Lesser of $2126.20 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2126.2,"standard_charge_algorithm": "Lesser of $2126.20 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2126.2,"standard_charge_algorithm": "Lesser of $2126.20 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2551.44,"standard_charge_algorithm": "Lesser of $2551.44 or 120 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":2275.03,"standard_charge_algorithm": "Lesser of $2275.03 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":2232.51,"standard_charge_algorithm": "Lesser of $2232.51 or 105 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2168.72,"standard_charge_algorithm": "Lesser of $2168.72 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC","code_information":[{"code":"016","type":"MS-DRG"}],"standard_charges":[{"minimum":34784.61,"maximum":157013.84,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":74400.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_percentage":29,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_percentage":44,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_percentage":26,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_percentage":37,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":69028,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":90074,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":142151,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":81744,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":67636.73,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":48891,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":71827,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":71827,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":75805,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":65221.14,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":157013.84,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":111531,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":111531,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":34784.61,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":44462,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":81213,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":60311,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":90225,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":90225,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":49278.19,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":49761.31,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":48795.07,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":51693.79,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":46741.82,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":57974.34,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":51693.79,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":50727.55,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":49278.19,"methodology":"case rate"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC","code_information":[{"code":"017","type":"MS-DRG"}],"standard_charges":[{"minimum":34784.61,"maximum":157013.84,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":74400.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_percentage":29,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_percentage":44,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_percentage":26,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_percentage":37,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":49579,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":90074,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":142151,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":81744,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":67636.73,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":48891,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":71827,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":71827,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":75805,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":65221.14,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":157013.84,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":111531,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":111531,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":34784.61,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":44462,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":81213,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":60311,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":90225,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":90225,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":72467.93,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":49278.19,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":49761.31,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":48795.07,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":51693.79,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":48311.95,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":46741.82,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":57974.34,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":51693.79,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":50727.55,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":49278.19,"methodology":"case rate"}]}]},{"description":"CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES","code_information":[{"code":"018","type":"MS-DRG"}],"standard_charges":[{"minimum":211873.83,"maximum":956374.9,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":453174.57,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":410067,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":562788,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":888174,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":510744,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":441403.8,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":441403.8,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":411976.88,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":441403.8,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":305474,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":448782,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":448782,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":473635,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":397263.42,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":956374.9,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":696857,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":696857,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":211873.83,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":441403.8,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":265193,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":507426,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":376826,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":563731,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":563731,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":441403.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":300154.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":294269.2,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":303097.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":294269.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":294269.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":297211.9,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":314868.05,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":294269.2,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":294269.2,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":284705.46,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":353123.04,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":314868.05,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":308982.66,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":300154.59,"methodology":"case rate"}]}]},{"description":"SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS","code_information":[{"code":"019","type":"MS-DRG"}],"standard_charges":[{"minimum":45358.45,"maximum":204742.98,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":97016.68,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":124164,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":166991,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":64632,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":185546,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":127876,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":80942,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":118299,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":186696,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":107359,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":94496.76,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":94496.76,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":88196.98,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":94496.76,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":64211,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":94335,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":94335,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":99559,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":85047.09,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":204742.98,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":146481,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":146481,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":45358.45,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":94496.76,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":57537,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":106662,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":79210,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":118497,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":118497,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":94496.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":64257.8,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":62997.84,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":64887.78,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":62997.84,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":62997.84,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":63627.82,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":67407.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":62997.84,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":62997.84,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":60950.42,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":75597.41,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":67407.69,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":66147.74,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":64257.8,"methodology":"case rate"}]}]},{"description":"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC","code_information":[{"code":"020","type":"MS-DRG"}],"standard_charges":[{"minimum":46106.46,"maximum":208119.41,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":98616.58,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":105546,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":120296,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":189847,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":109171,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":96055.11,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":96055.11,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":89651.44,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":96055.11,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":65295,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":95927,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":95927,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":101239,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":86449.6,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":208119.41,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":148953,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":148953,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":46106.46,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":96055.11,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":60840,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":108462,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":80547,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":120497,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":120497,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":96055.11,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":65317.48,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":64036.74,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":65957.85,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":64036.74,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":64036.74,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":64677.11,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":68519.32,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":64036.74,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":64036.74,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":61955.55,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":76844.09,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":68519.32,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":67238.58,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":65317.48,"methodology":"case rate"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0201","type":"APR-DRG"}],"standard_charges":[{"minimum":9993,"maximum":36974.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":10492.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11491.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":27580.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9993,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":23983.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9993,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10192.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10192.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":36974.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10192.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":24482.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":36974.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10292.79,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":10292.79,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":24682.71,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10292.79,"methodology":"case rate"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0202","type":"APR-DRG"}],"standard_charges":[{"minimum":11939,"maximum":44174.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":12535.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13729.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":32951.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11939,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":28653.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11939,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":12177.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12177.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":44174.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12177.78,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":29250.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":44174.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12297.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":12297.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":29489.33,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12297.17,"methodology":"case rate"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0203","type":"APR-DRG"}],"standard_charges":[{"minimum":21280,"maximum":78736,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":22344,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24472,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":58732.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21280,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":51072,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21280,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":21705.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21705.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":78736,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21705.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":52136,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":78736,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21918.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":21918.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":52561.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21918.4,"methodology":"case rate"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0204","type":"APR-DRG"}],"standard_charges":[{"minimum":33847,"maximum":125233.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":35539.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38924.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":93417.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":33847,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":81232.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":33847,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":34523.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":34523.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":125233.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":34523.94,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":82925.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":125233.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":34862.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":34862.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":83602.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":34862.41,"methodology":"case rate"}]}]},{"description":"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC","code_information":[{"code":"021","type":"MS-DRG"}],"standard_charges":[{"minimum":31941.29,"maximum":144179.4,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":68318.86,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":77023,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":82484,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":130173,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":74856,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":66544.34,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":66544.34,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":62108.05,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":66544.34,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":44771,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":65775,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":65775,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":69417,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":59889.91,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":144179.4,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":102133,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":102133,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":31941.29,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":66544.34,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":44206,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":74370,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":55229,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":82622,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":82622,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":66544.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":45250.15,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":44362.89,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":45693.78,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":44362.89,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":44362.89,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":44806.52,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":47468.3,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":44362.89,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":44362.89,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":42921.1,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":53235.47,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":47468.3,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":46581.04,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":45250.15,"methodology":"case rate"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0211","type":"APR-DRG"}],"standard_charges":[{"minimum":10787,"maximum":39911.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11326.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12405.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":29772.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10787,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":25888.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10787,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11002.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11002.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":39911.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11002.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":26428.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":39911.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11110.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11110.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":26643.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11110.61,"methodology":"case rate"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0212","type":"APR-DRG"}],"standard_charges":[{"minimum":14656,"maximum":54227.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":15388.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16854.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":40450.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14656,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":35174.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14656,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":14949.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14949.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":54227.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14949.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":35907.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":54227.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15095.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":15095.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":36200.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15095.68,"methodology":"case rate"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0213","type":"APR-DRG"}],"standard_charges":[{"minimum":23061,"maximum":85325.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":24214.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":26520.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":63648.36,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23061,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":55346.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23061,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":23522.22,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23522.22,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":85325.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23522.22,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":56499.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":85325.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23752.83,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":23752.83,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":56960.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23752.83,"methodology":"case rate"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0214","type":"APR-DRG"}],"standard_charges":[{"minimum":40294,"maximum":149087.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":42308.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":46338.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":111211.44,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":40294,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":96705.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":40294,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":41099.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":41099.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":149087.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":41099.88,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":98720.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":149087.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":41502.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":41502.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":99526.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":41502.82,"methodology":"case rate"}]}]},{"description":"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC","code_information":[{"code":"022","type":"MS-DRG"}],"standard_charges":[{"minimum":20777.65,"maximum":93787.98,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":44441.08,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":49447,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":52684,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":83144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":47812,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43286.76,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":43286.76,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":40400.98,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":43286.76,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":28596,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":42012,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":42012,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":44338,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":38958.09,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":93787.98,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":65235,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":65235,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":20777.65,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":43286.76,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":28236,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":47502,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":35276,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":52772,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":52772,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":43286.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":29435,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":28857.84,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":29723.58,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":28857.84,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":28857.84,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":29146.42,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":30877.89,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":28857.84,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":28857.84,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":27919.97,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":34629.41,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":30877.89,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":30300.74,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":29435,"methodology":"case rate"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0221","type":"APR-DRG"}],"standard_charges":[{"minimum":6029,"maximum":22307.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6330.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6933.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":16640.04,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6029,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":14469.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6029,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6149.58,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6149.58,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":22307.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6149.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":14771.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":22307.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6209.87,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6209.87,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":14891.63,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6209.87,"methodology":"case rate"}]}]},{"description":"HC LAB ABO GNOTYP NEXT GNRJ SEQ ABO","code_information":[{"code":"0221U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":297.9,"maximum":662,"gross_charge":662,"discounted_cash":231.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":463.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":430.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":430.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":463.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":430.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":463.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":662,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":496.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":331,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":562.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":364.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":364.1,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":297.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":364.1,"methodology":"fee schedule"}]}]},{"description":"HC LAB ABO GNOTYP NEXT GNRJ SEQ ABO","code_information":[{"code":"0221U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":178.74,"maximum":893.2,"gross_charge":662,"discounted_cash":231.7,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":423.24,"standard_charge_algorithm": "Lesser of $423.24 or 154 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":463.4,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":593.89,"standard_charge_algorithm": "Lesser of $593.89 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":662,"standard_charge_algorithm": "Lesser of $1704.77 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":512.71,"standard_charge_algorithm": "Lesser of $512.71 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":662,"standard_charge_algorithm": "Lesser of $1640.68 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":662,"standard_charge_algorithm": "Lesser of $1234.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":453.47,"standard_charge_algorithm": "Lesser of $453.47 or 165 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":397.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":457.32,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":625.24,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":414.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":463.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":412.25,"standard_charge_algorithm": "Lesser of $412.25 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":412.25,"standard_charge_algorithm": "Lesser of $412.25 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":430.3,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":384.76,"standard_charge_algorithm": "Lesser of $384.76 or 140 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":430.3,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":412.25,"standard_charge_algorithm": "Lesser of $412.25 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":463.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":430.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":463.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":371.02,"standard_charge_algorithm": "Lesser of $371.02 or 135 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":662,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":496.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":893.2,"standard_charge_algorithm": "Lesser of $893.20 or 325 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":197.88,"standard_charge_algorithm": "Lesser of $197.88 or 72 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":412.25,"standard_charge_algorithm": "Lesser of $412.25 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":297.9,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":562.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":412.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":412.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":412.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":311.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":412.25,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":412.25,"standard_charge_algorithm": "Lesser of $412.25 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":364.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":364.1,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":239.52,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":546.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":271.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":364.1,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":280.33,"standard_charge_algorithm": "Lesser of $280.33 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":274.83,"standard_charge_algorithm": "Lesser of $274.83 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":283.07,"standard_charge_algorithm": "Lesser of $283.07 or 103 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":274.83,"standard_charge_algorithm": "Lesser of $274.83 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":274.83,"standard_charge_algorithm": "Lesser of $274.83 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":277.58,"standard_charge_algorithm": "Lesser of $277.58 or 101 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":294.07,"standard_charge_algorithm": "Lesser of $294.07 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":274.83,"standard_charge_algorithm": "Lesser of $274.83 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":274.83,"standard_charge_algorithm": "Lesser of $274.83 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":274.83,"standard_charge_algorithm": "Lesser of $274.83 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":329.8,"standard_charge_algorithm": "Lesser of $329.80 or 120 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":178.74,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":294.07,"standard_charge_algorithm": "Lesser of $294.07 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":288.57,"standard_charge_algorithm": "Lesser of $288.57 or 105 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":280.33,"standard_charge_algorithm": "Lesser of $280.33 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0222","type":"APR-DRG"}],"standard_charges":[{"minimum":7413,"maximum":27428.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7783.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8524.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":20459.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7413,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":17791.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7413,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7561.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7561.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27428.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7561.26,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18161.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27428.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7635.39,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7635.39,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":18310.11,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7635.39,"methodology":"case rate"}]}]},{"description":"HC RHD&RHCE GNTYP NEXT GNRJ SEQ","code_information":[{"code":"0222U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":481.5,"maximum":1070,"gross_charge":1070,"discounted_cash":374.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":749,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":695.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":695.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":749,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":695.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":749,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1070,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":802.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":535,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":909.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":588.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":588.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":481.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":588.5,"methodology":"fee schedule"}]}]},{"description":"HC RHD&RHCE GNTYP NEXT GNRJ SEQ","code_information":[{"code":"0222U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":203.67,"maximum":1070,"gross_charge":1070,"discounted_cash":374.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":435.64,"standard_charge_algorithm": "Lesser of $435.64 or 154 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":749,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":593.89,"standard_charge_algorithm": "Lesser of $593.89 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1070,"standard_charge_algorithm": "Lesser of $1704.77 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":512.71,"standard_charge_algorithm": "Lesser of $512.71 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1070,"standard_charge_algorithm": "Lesser of $1640.68 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":1070,"standard_charge_algorithm": "Lesser of $1234.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":466.75,"standard_charge_algorithm": "Lesser of $466.75 or 165 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":642,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":470.71,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":643.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":426.58,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":749,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":424.32,"standard_charge_algorithm": "Lesser of $424.32 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":424.32,"standard_charge_algorithm": "Lesser of $424.32 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":695.5,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":396.03,"standard_charge_algorithm": "Lesser of $396.03 or 140 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":695.5,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":424.32,"standard_charge_algorithm": "Lesser of $424.32 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":749,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":695.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":749,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":381.89,"standard_charge_algorithm": "Lesser of $381.89 or 135 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1070,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":802.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":919.36,"standard_charge_algorithm": "Lesser of $919.36 or 325 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":203.67,"standard_charge_algorithm": "Lesser of $203.67 or 72 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":424.32,"standard_charge_algorithm": "Lesser of $424.32 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":481.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":909.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":424.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":424.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":424.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":502.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":424.32,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":424.32,"standard_charge_algorithm": "Lesser of $424.32 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":588.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":588.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":387.13,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":884.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":438.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":588.5,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":288.54,"standard_charge_algorithm": "Lesser of $288.54 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":282.88,"standard_charge_algorithm": "Lesser of $282.88 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":291.37,"standard_charge_algorithm": "Lesser of $291.37 or 103 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":282.88,"standard_charge_algorithm": "Lesser of $282.88 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":282.88,"standard_charge_algorithm": "Lesser of $282.88 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":285.71,"standard_charge_algorithm": "Lesser of $285.71 or 101 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":302.68,"standard_charge_algorithm": "Lesser of $302.68 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":282.88,"standard_charge_algorithm": "Lesser of $282.88 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":282.88,"standard_charge_algorithm": "Lesser of $282.88 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":282.88,"standard_charge_algorithm": "Lesser of $282.88 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":339.46,"standard_charge_algorithm": "Lesser of $339.46 or 120 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":288.9,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":302.68,"standard_charge_algorithm": "Lesser of $302.68 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":297.02,"standard_charge_algorithm": "Lesser of $297.02 or 105 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":288.54,"standard_charge_algorithm": "Lesser of $288.54 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0223","type":"APR-DRG"}],"standard_charges":[{"minimum":11046,"maximum":40870.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11598.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12702.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":30486.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11046,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":26510.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11046,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11266.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11266.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":40870.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11266.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":27062.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":40870.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11377.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11377.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":27283.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11377.38,"methodology":"case rate"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0224","type":"APR-DRG"}],"standard_charges":[{"minimum":39990,"maximum":147963,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":41989.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":45988.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":110372.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":39990,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":95976,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":39990,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":40789.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":40789.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":147963,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":40789.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":97975.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":147963,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":41189.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":41189.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":98775.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":41189.7,"methodology":"case rate"}]}]},{"description":"HC LAB FCT DS DNA&RNA 21 SARSCOV2","code_information":[{"code":"0225U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":595.8,"maximum":1324,"gross_charge":1324,"discounted_cash":463.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1324,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":993,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":662,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1125.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":595.8,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":728.2,"methodology":"fee schedule"}]}]},{"description":"HC LAB FCT DS DNA&RNA 21 SARSCOV2","code_information":[{"code":"0225U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":1354.54,"gross_charge":1324,"discounted_cash":463.4,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":641.84,"standard_charge_algorithm": "Lesser of $641.84 or 154 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":579.32,"standard_charge_algorithm": "Lesser of $579.32 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1324,"standard_charge_algorithm": "Lesser of $1662.95 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":500.14,"standard_charge_algorithm": "Lesser of $500.14 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1324,"standard_charge_algorithm": "Lesser of $1600.44 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":1204.49,"standard_charge_algorithm": "Lesser of $1204.49 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":687.69,"standard_charge_algorithm": "Lesser of $687.69 or 165 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":794.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":625.17,"standard_charge_algorithm": "Lesser of $625.17 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":625.17,"standard_charge_algorithm": "Lesser of $625.17 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":583.49,"standard_charge_algorithm": "Lesser of $583.49 or 140 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":625.17,"standard_charge_algorithm": "Lesser of $625.17 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":562.65,"standard_charge_algorithm": "Lesser of $562.65 or 135 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1324,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":993,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1354.54,"standard_charge_algorithm": "Lesser of $1354.54 or 325 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":300.08,"standard_charge_algorithm": "Lesser of $300.08 or 72 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":625.17,"standard_charge_algorithm": "Lesser of $625.17 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":595.8,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1125.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":625.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":625.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":625.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":622.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":625.16,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":625.17,"standard_charge_algorithm": "Lesser of $625.17 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":479.03,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1093.89,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":542.84,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":425.12,"standard_charge_algorithm": "Lesser of $425.12 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":416.78,"standard_charge_algorithm": "Lesser of $416.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":429.28,"standard_charge_algorithm": "Lesser of $429.28 or 103 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":416.78,"standard_charge_algorithm": "Lesser of $416.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":416.78,"standard_charge_algorithm": "Lesser of $416.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":420.95,"standard_charge_algorithm": "Lesser of $420.95 or 101 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":445.95,"standard_charge_algorithm": "Lesser of $445.95 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":416.78,"standard_charge_algorithm": "Lesser of $416.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":416.78,"standard_charge_algorithm": "Lesser of $416.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":416.78,"standard_charge_algorithm": "Lesser of $416.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":500.14,"standard_charge_algorithm": "Lesser of $500.14 or 120 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":357.48,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":445.95,"standard_charge_algorithm": "Lesser of $445.95 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":437.62,"standard_charge_algorithm": "Lesser of $437.62 or 105 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":425.12,"standard_charge_algorithm": "Lesser of $425.12 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"HC LAB SVNT SARSCOV2 ELISA PLSM SRM","code_information":[{"code":"0226U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":595.8,"maximum":1324,"gross_charge":1324,"discounted_cash":463.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1324,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":993,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":662,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1125.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":595.8,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":728.2,"methodology":"fee schedule"}]}]},{"description":"HC LAB SVNT SARSCOV2 ELISA PLSM SRM","code_information":[{"code":"0226U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":30.44,"maximum":1324,"gross_charge":1324,"discounted_cash":463.4,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":65.11,"standard_charge_algorithm": "Lesser of $65.11 or 154 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":58.77,"standard_charge_algorithm": "Lesser of $58.77 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":168.7,"standard_charge_algorithm": "Lesser of $168.70 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":50.74,"standard_charge_algorithm": "Lesser of $50.74 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":162.36,"standard_charge_algorithm": "Lesser of $162.36 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":122.19,"standard_charge_algorithm": "Lesser of $122.19 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":69.76,"standard_charge_algorithm": "Lesser of $69.76 or 165 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":794.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":63.42,"standard_charge_algorithm": "Lesser of $63.42 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":63.42,"standard_charge_algorithm": "Lesser of $63.42 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":59.19,"standard_charge_algorithm": "Lesser of $59.19 or 140 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":63.42,"standard_charge_algorithm": "Lesser of $63.42 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":860.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":926.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":57.08,"standard_charge_algorithm": "Lesser of $57.08 or 135 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1324,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":993,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":137.41,"standard_charge_algorithm": "Lesser of $137.41 or 325 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":30.44,"standard_charge_algorithm": "Lesser of $30.44 or 72 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":63.42,"standard_charge_algorithm": "Lesser of $63.42 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":595.8,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1125.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":63.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":63.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":63.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":622.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":63.2,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":63.42,"standard_charge_algorithm": "Lesser of $63.42 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":479.03,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1093.89,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":542.84,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":728.2,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":43.13,"standard_charge_algorithm": "Lesser of $43.13 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":42.28,"standard_charge_algorithm": "Lesser of $42.28 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":43.55,"standard_charge_algorithm": "Lesser of $43.55 or 103 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":42.28,"standard_charge_algorithm": "Lesser of $42.28 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":42.28,"standard_charge_algorithm": "Lesser of $42.28 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":42.7,"standard_charge_algorithm": "Lesser of $42.70 or 101 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":45.24,"standard_charge_algorithm": "Lesser of $45.24 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":42.28,"standard_charge_algorithm": "Lesser of $42.28 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":42.28,"standard_charge_algorithm": "Lesser of $42.28 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":42.28,"standard_charge_algorithm": "Lesser of $42.28 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":50.74,"standard_charge_algorithm": "Lesser of $50.74 or 120 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":357.48,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":45.24,"standard_charge_algorithm": "Lesser of $45.24 or 107 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":44.39,"standard_charge_algorithm": "Lesser of $44.39 or 105 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":43.13,"standard_charge_algorithm": "Lesser of $43.13 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR","code_information":[{"code":"023","type":"MS-DRG"}],"standard_charges":[{"minimum":32935.27,"maximum":148666.15,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":70444.89,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":65023,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":85137,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":134361,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":77264,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68615.15,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":68615.15,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":64040.81,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":68615.15,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":46211,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":67891,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":67891,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":71650,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":61753.64,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":148666.15,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":105419,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":105419,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":32935.27,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68615.15,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":40804,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":76762,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":57005,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":85280,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":85280,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":68615.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":46658.3,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":45743.43,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":47115.74,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":45743.43,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":45743.43,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":46200.87,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":48945.48,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":45743.43,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":45743.43,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":44256.77,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":54892.12,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":48945.48,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":48030.61,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":46658.3,"methodology":"case rate"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0231","type":"APR-DRG"}],"standard_charges":[{"minimum":7626,"maximum":28216.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8007.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8769.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":21047.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7626,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":18302.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7626,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7778.52,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7778.52,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28216.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7778.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18683.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28216.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7854.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7854.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":18836.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7854.78,"methodology":"case rate"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0232","type":"APR-DRG"}],"standard_charges":[{"minimum":11088,"maximum":41025.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11642.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12751.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":30602.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11088,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":26611.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11088,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11309.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11309.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":41025.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11309.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":27165.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":41025.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11420.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11420.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":27387.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11420.64,"methodology":"case rate"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0233","type":"APR-DRG"}],"standard_charges":[{"minimum":22587,"maximum":83571.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":23716.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25975.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":62340.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22587,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":54208.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22587,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":23038.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23038.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":83571.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23038.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":55338.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":83571.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23264.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":23264.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":55789.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23264.61,"methodology":"case rate"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0234","type":"APR-DRG"}],"standard_charges":[{"minimum":46397,"maximum":171668.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":48716.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":53356.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":128055.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":46397,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":111352.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":46397,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":47324.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":47324.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":171668.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":47324.94,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":113672.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":171668.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":47788.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":47788.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":114600.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":47788.91,"methodology":"case rate"}]}]},{"description":"HC TRLUML PERIP ATHRC RENAL EA.","code_information":[{"code":"0234T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":8081.55,"maximum":17959,"gross_charge":17959,"discounted_cash":6285.65,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12571.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11673.35,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11673.35,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12571.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11673.35,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12571.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":17959,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":13469.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":8979.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":15265.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9877.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9877.45,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":8081.55,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9877.45,"methodology":"fee schedule"}]}]},{"description":"HC TRLUML PERIP ATHRC RENAL EA.","code_information":[{"code":"0234T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1369,"maximum":36916.56,"gross_charge":17959,"discounted_cash":6285.65,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":17492.77,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":12571.3,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":13648.84,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":8323.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":20213.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":9115.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":21798.66,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":16547.16,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":11176.45,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":16797.53,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":10775.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12571.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11673.35,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":15902.52,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11673.35,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12571.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11673.35,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12571.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":15334.57,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":17959,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":13469.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":36916.56,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8178.44,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8081.55,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":15265.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":8440.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9877.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9877.45,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":6497.57,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14837.73,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":7363.19,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1975.49,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2647.16,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1975.49,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9877.45,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6163.53,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2015,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2706.43,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6163.53,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11586.12,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":11699.71,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":11472.53,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":12154.07,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":13630.73,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":4848.93,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":12154.07,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":11926.89,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":11586.12,"methodology":"case rate"}]}]},{"description":"HC TRLUML PERIP ATHRC ABD AORTA","code_information":[{"code":"0236T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":8485.65,"maximum":18857,"gross_charge":18857,"discounted_cash":6599.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":13199.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":12257.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":12257.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":13199.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":12257.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":13199.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":18857,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":14142.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":9428.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":16028.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10371.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":10371.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":8485.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":10371.35,"methodology":"fee schedule"}]}]},{"description":"HC TRLUML PERIP ATHRC ABD AORTA","code_information":[{"code":"0236T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1369,"maximum":36916.56,"gross_charge":18857,"discounted_cash":6599.95,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":17492.77,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":13199.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":14331.32,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":8323.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":20213.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":9115.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":21798.66,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":16547.16,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":11176.45,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":16797.53,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":11314.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":13199.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":12257.05,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":15902.52,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":12257.05,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":13199.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":12257.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":13199.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":15334.57,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":18857,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":14142.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":36916.56,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8178.44,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8485.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":16028.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":8862.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10371.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":10371.35,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":6822.47,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15579.66,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":7731.37,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2074.27,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2779.53,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2074.27,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":10371.35,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6471.73,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2115.76,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2841.75,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6471.73,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11586.12,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":11699.71,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":11472.53,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":12154.07,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":13630.73,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":5091.39,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":12154.07,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":11926.89,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":11586.12,"methodology":"case rate"}]}]},{"description":"HC TRLUML PERIP ATHRC BRCHOCPH","code_information":[{"code":"0237T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":6982.65,"maximum":15517,"gross_charge":15517,"discounted_cash":5430.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":10861.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":10086.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":10086.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":10861.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":10086.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":10861.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":15517,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":11637.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":7758.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":13189.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":8534.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":8534.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":6982.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":8534.35,"methodology":"fee schedule"}]}]},{"description":"HC TRLUML PERIP ATHRC BRCHOCPH","code_information":[{"code":"0237T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1369,"maximum":36916.56,"gross_charge":15517,"discounted_cash":5430.95,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":17492.77,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":10861.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":11792.92,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":8323.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":20213.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":9115.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":21798.66,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":16547.16,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":11176.45,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":16797.53,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":9310.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":10861.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":10086.05,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":15902.52,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":10086.05,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":10861.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":10086.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":10861.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":15334.57,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":15517,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":11637.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":36916.56,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8178.44,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6982.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":13189.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":7292.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":8534.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":8534.35,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":5614.06,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12820.15,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":6361.97,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1706.87,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2287.21,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1706.87,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":8534.35,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5325.44,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1741.01,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2338.42,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5325.44,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11586.12,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":11699.71,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":11472.53,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":12154.07,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":13630.73,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":4189.59,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":12154.07,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":11926.89,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":11586.12,"methodology":"case rate"}]}]},{"description":"HC TRLUML PERIP ATHRC ILIAC ART","code_information":[{"code":"0238T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":7976.7,"maximum":17726,"gross_charge":17726,"discounted_cash":6204.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12408.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11521.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11521.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12408.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11521.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12408.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":17726,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":13294.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":8863,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":15067.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9749.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9749.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":7976.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9749.3,"methodology":"fee schedule"}]}]},{"description":"HC TRLUML PERIP ATHRC ILIAC ART","code_information":[{"code":"0238T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1518.3,"maximum":58453.88,"gross_charge":17726,"discounted_cash":6204.1,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":27698.15,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":3212,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":2670,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":12408.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":13471.76,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":13389.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":32517.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":14664.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":35067.93,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":26619.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":11176.45,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26857.58,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":10635.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12408.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11521.9,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":25180.13,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11521.9,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12408.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11521.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12408.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":24280.84,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":17726,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":13294.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":58453.88,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":12949.78,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7976.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":15067.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":8331.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9749.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9749.3,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":6413.27,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14645.23,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":7267.66,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1949.86,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2612.82,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1949.86,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9749.3,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6083.57,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1988.86,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2671.31,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6083.57,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18345.53,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":18525.38,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":18165.67,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":19244.82,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":21582.97,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":4786.02,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":19244.82,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":18885.1,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":18345.53,"methodology":"case rate"}]}]},{"description":"CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC","code_information":[{"code":"024","type":"MS-DRG"}],"standard_charges":[{"minimum":22294.34,"maximum":100634.17,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":47685.12,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":44799,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":56733,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":89534,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":51486,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46446.54,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":46446.54,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":43350.11,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":46446.54,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":30794,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":45240,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":45240,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":47746,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":41801.89,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":100634.17,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":70248,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":70248,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":22294.34,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":46446.54,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":27272,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":51152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":37987,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":56828,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":56828,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":46446.54,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":31583.65,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":30964.36,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":31893.3,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":30964.36,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":30964.36,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":31274.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":33131.87,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":30964.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":30964.36,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":29958.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":37157.24,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":33131.87,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":32512.58,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":31583.65,"methodology":"case rate"}]}]},{"description":"COVID/FLU A/B TRIPLEX","code_information":[{"code":"0240U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":326.7,"maximum":726,"gross_charge":726,"discounted_cash":254.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":508.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":508.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":508.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":726,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":544.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":363,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":617.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":399.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":399.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":326.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":399.3,"methodology":"fee schedule"}]}]},{"description":"COVID/FLU A/B TRIPLEX","code_information":[{"code":"0240U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":726,"gross_charge":726,"discounted_cash":254.1,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":508.2,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":198.26,"standard_charge_algorithm": "Lesser of $198.26 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":569.09,"standard_charge_algorithm": "Lesser of $569.09 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":171.16,"standard_charge_algorithm": "Lesser of $171.16 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":547.7,"standard_charge_algorithm": "Lesser of $547.70 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":412.2,"standard_charge_algorithm": "Lesser of $412.20 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":235.34,"standard_charge_algorithm": "Lesser of $235.34 or 165 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":435.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":508.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":508.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":508.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":192.55,"standard_charge_algorithm": "Lesser of $192.55 or 135 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":726,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":544.5,"methodology":"fee schedule"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":326.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":617.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":213.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":213.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":213.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":341.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":213.9,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":399.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":399.3,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":262.67,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":599.83,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":297.66,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":399.3,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":145.48,"standard_charge_algorithm": "Lesser of $145.48 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":146.91,"standard_charge_algorithm": "Lesser of $146.91 or 103 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":144.06,"standard_charge_algorithm": "Lesser of $144.06 or 101 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":196.02,"methodology":"fee schedule"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":149.76,"standard_charge_algorithm": "Lesser of $149.76 or 105 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":145.48,"standard_charge_algorithm": "Lesser of $145.48 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0241","type":"APR-DRG"}],"standard_charges":[{"minimum":4358,"maximum":16124.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4575.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5011.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":12028.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4358,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10459.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4358,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4445.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4445.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16124.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4445.16,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10677.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16124.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4488.74,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4488.74,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10764.26,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4488.74,"methodology":"case rate"}]}]},{"description":"HC LAB NFCT DS VIR RESP RNA 4 TRGT","code_information":[{"code":"0241U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":319.05,"maximum":709,"gross_charge":709,"discounted_cash":248.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":496.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":460.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":460.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":496.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":460.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":496.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":709,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":531.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":354.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":602.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":389.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":389.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":319.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":389.95,"methodology":"fee schedule"}]}]},{"description":"HC LAB NFCT DS VIR RESP RNA 4 TRGT","code_information":[{"code":"0241U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":709,"gross_charge":709,"discounted_cash":248.15,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":496.3,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":198.26,"standard_charge_algorithm": "Lesser of $198.26 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":569.09,"standard_charge_algorithm": "Lesser of $569.09 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":171.16,"standard_charge_algorithm": "Lesser of $171.16 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":547.7,"standard_charge_algorithm": "Lesser of $547.70 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":412.2,"standard_charge_algorithm": "Lesser of $412.20 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":235.34,"standard_charge_algorithm": "Lesser of $235.34 or 165 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":425.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":496.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":460.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":460.85,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":496.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":460.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":496.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":192.55,"standard_charge_algorithm": "Lesser of $192.55 or 135 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":709,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":531.75,"methodology":"fee schedule"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":319.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":602.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":213.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":213.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":213.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":333.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":213.9,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":213.94,"standard_charge_algorithm": "Lesser of $213.94 or 150 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":389.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":389.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":256.52,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":585.78,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":290.69,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":389.95,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":145.48,"standard_charge_algorithm": "Lesser of $145.48 or 102 Percent of Billed Charges","median_amount":145.48,"10th_percentile":145.48,"90th_percentile":145.48,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":146.91,"standard_charge_algorithm": "Lesser of $146.91 or 103 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":144.06,"standard_charge_algorithm": "Lesser of $144.06 or 101 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","median_amount":142.63,"10th_percentile":142.63,"90th_percentile":142.63,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","median_amount":142.63,"10th_percentile":142.63,"90th_percentile":142.63,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":191.43,"methodology":"fee schedule"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":149.76,"standard_charge_algorithm": "Lesser of $149.76 or 105 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":145.48,"standard_charge_algorithm": "Lesser of $145.48 or 102 Percent of Billed Charges","median_amount":145.48,"10th_percentile":145.48,"90th_percentile":145.48,"count":"1 through 10","methodology":"fee schedule"}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0242","type":"APR-DRG"}],"standard_charges":[{"minimum":6637,"maximum":24556.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6968.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7632.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":18318.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6637,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":15928.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6637,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6769.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6769.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24556.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6769.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":16260.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24556.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6836.11,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6836.11,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16393.39,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6836.11,"methodology":"case rate"}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0243","type":"APR-DRG"}],"standard_charges":[{"minimum":11881,"maximum":43959.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":12475.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13663.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":32791.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11881,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":28514.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11881,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":12118.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12118.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":43959.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12118.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":29108.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":43959.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12237.43,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":12237.43,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":29346.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12237.43,"methodology":"case rate"}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0244","type":"APR-DRG"}],"standard_charges":[{"minimum":22860,"maximum":84582,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":24003,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":26289,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":63093.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22860,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":54864,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22860,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":23317.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23317.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":84582,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23317.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":56007,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":84582,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23545.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":23545.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":56464.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23545.8,"methodology":"case rate"}]}]},{"description":"CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC","code_information":[{"code":"025","type":"MS-DRG"}],"standard_charges":[{"minimum":26043.33,"maximum":117556.66,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":55703.78,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":51512,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":66740,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":105327,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":60568,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54256.92,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":54256.92,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":50639.8,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":54256.92,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":36226,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":53220,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":53220,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":56168,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":48831.23,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":117556.66,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":82639,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":82639,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":26043.33,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":54256.92,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":31786,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":60175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":44687,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":66852,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":66852,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":54256.92,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":36894.71,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":36171.28,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":37256.42,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":36171.28,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":36171.28,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":36533,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":38703.27,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":36171.28,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":36171.28,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":34995.72,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":43405.54,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":38703.27,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":37979.85,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":36894.71,"methodology":"case rate"}]}]},{"description":"CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC","code_information":[{"code":"026","type":"MS-DRG"}],"standard_charges":[{"minimum":18140.06,"maximum":81882.19,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":38799.57,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":34302,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":45643,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":72033,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":41423,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":37791.78,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":37791.78,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":35272.33,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":37791.78,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":24775,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":36397,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":36397,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":38413,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":34012.61,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":81882.19,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":56517,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":56517,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":18140.06,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":37791.78,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":21256,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":41153,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":30562,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":45720,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":45720,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":37791.78,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":25698.42,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":25194.52,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":25950.36,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":25194.52,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":25194.52,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":25446.47,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":26958.14,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":25194.52,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":25194.52,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":24375.7,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":30233.43,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":26958.14,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":26454.25,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":25698.42,"methodology":"case rate"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0261","type":"APR-DRG"}],"standard_charges":[{"minimum":6638,"maximum":24560.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6969.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7633.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":18320.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6638,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":15931.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6638,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6770.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6770.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24560.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6770.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":16263.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24560.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6837.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6837.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16395.86,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6837.14,"methodology":"case rate"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0262","type":"APR-DRG"}],"standard_charges":[{"minimum":10740,"maximum":39738,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11277,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12351,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":29642.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10740,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":25776,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10740,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10954.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10954.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":39738,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10954.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":26313,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":39738,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11062.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11062.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":26527.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11062.2,"methodology":"case rate"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0263","type":"APR-DRG"}],"standard_charges":[{"minimum":16267,"maximum":60187.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":17080.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18707.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":44896.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16267,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":39040.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":16267,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":16592.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":16592.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":60187.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16592.34,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":39854.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":60187.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16755.01,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":16755.01,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":40179.49,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":16755.01,"methodology":"case rate"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0264","type":"APR-DRG"}],"standard_charges":[{"minimum":43285,"maximum":160154.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":45449.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":49777.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":119466.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":43285,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":103884,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":43285,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":44150.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":44150.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":160154.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44150.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":106048.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":160154.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44583.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":44583.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":106913.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":44583.55,"methodology":"case rate"}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"026A0Z0","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"026Z0Z1","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"026Z0Z20BY0MZ0","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"027","type":"MS-DRG"}],"standard_charges":[{"minimum":14837.2,"maximum":66973.44,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":31735.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":28310,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":36827,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":58119,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":33421,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30910.82,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":30910.82,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":28850.1,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":30910.82,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":19989,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":29367,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":29367,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":30993,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":27819.74,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":66973.44,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":45600,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":45600,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":14837.2,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30910.82,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":17512,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":33204,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":24658,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":36889,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":36889,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":30910.82,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":21019.36,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20607.21,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":21225.43,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":20607.21,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":20607.21,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":20813.29,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":22049.72,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":20607.21,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20607.21,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":19937.48,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":24728.66,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":22049.72,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":21637.58,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":21019.36,"methodology":"case rate"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0271","type":"APR-DRG"}],"standard_charges":[{"minimum":9043,"maximum":33459.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9495.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10399.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":24958.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9043,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":21703.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9043,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9223.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9223.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33459.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9223.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":22155.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33459.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9314.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9314.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":22336.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9314.29,"methodology":"case rate"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0272","type":"APR-DRG"}],"standard_charges":[{"minimum":15043,"maximum":55659.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":15795.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":17299.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":41518.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15043,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":36103.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15043,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":15343.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15343.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":55659.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15343.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":36855.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":55659.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15494.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":15494.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":37156.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15494.29,"methodology":"case rate"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0273","type":"APR-DRG"}],"standard_charges":[{"minimum":21043,"maximum":77859.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":22095.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24199.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":58078.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21043,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":50503.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21043,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":21463.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21463.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":77859.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21463.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":51555.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":77859.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21674.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":21674.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":51976.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21674.29,"methodology":"case rate"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0274","type":"APR-DRG"}],"standard_charges":[{"minimum":23205,"maximum":85858.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":24365.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":26685.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":64045.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23205,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":55692,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23205,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":23669.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23669.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":85858.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23669.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":56852.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":85858.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23901.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":23901.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":57316.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23901.15,"methodology":"case rate"}]}]},{"description":"SPINAL PROCEDURES WITH MCC","code_information":[{"code":"028","type":"MS-DRG"}],"standard_charges":[{"minimum":35028.35,"maximum":158114.06,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":74921.74,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":66680,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":90724,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":143178,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":82335,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":72975.72,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":72975.72,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":68110.68,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":72975.72,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":49244,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":72346,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":72346,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":76352,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":65678.15,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":158114.06,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":112337,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":112337,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":35028.35,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":72975.72,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":43376,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":81800,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":60746,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":90876,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":90876,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":72975.72,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":49623.49,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":48650.48,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":50110,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":48650.48,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":48650.48,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":49136.99,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":52056.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":48650.48,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":48650.48,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":47069.34,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":58380.58,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":52056.02,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":51083.01,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":49623.49,"methodology":"case rate"}]}]},{"description":"SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS","code_information":[{"code":"029","type":"MS-DRG"}],"standard_charges":[{"minimum":19806.58,"maximum":89404.68,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":42364.07,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":38773,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":50092,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":79054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":45460,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41263.7,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":41263.7,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":38512.79,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":41263.7,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":27189,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":39945,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":39945,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":42157,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":37137.33,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":89404.68,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":62025,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":62025,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":19806.58,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":41263.7,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":24676,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":45164,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":33540,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":50176,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":50176,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":41263.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":28059.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":27509.13,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":28334.41,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":27509.13,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":27509.13,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":27784.23,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":29434.77,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":27509.13,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":27509.13,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":26615.09,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":33010.96,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":29434.77,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":28884.59,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":28059.32,"methodology":"case rate"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0291","type":"APR-DRG"}],"standard_charges":[{"minimum":15497,"maximum":57338.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":16271.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":17821.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":42771.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15497,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":37192.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15497,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":15806.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15806.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":57338.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15806.94,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":37967.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":57338.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15961.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":15961.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":38277.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15961.91,"methodology":"case rate"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0292","type":"APR-DRG"}],"standard_charges":[{"minimum":16406,"maximum":60702.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":17226.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18866.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":45280.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16406,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":39374.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":16406,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":16734.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":16734.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":60702.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16734.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":40194.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":60702.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16898.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":16898.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":40522.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":16898.18,"methodology":"case rate"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0293","type":"APR-DRG"}],"standard_charges":[{"minimum":22204,"maximum":82154.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":23314.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25534.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":61283.04,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22204,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":53289.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22204,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22648.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22648.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":82154.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22648.08,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":54399.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":82154.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22870.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":22870.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":54843.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22870.12,"methodology":"case rate"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0294","type":"APR-DRG"}],"standard_charges":[{"minimum":25195,"maximum":93221.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":26454.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":28974.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":69538.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25195,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":60468,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25195,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25698.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25698.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":93221.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25698.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":61727.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":93221.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25950.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":25950.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":62231.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25950.85,"methodology":"case rate"}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02HA0QZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02HA0RS","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02HA3QZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02HA3RS","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02HA4QZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02HA4RS","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02PA0RZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02PA4RZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02RK0JZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02RL0JZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02WA0JZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02WA0QZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02WA0RZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02WA3QZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02WA4QZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VAD SERVICES","code_information":[{"code":"02WA4RZ","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":53,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"SPINAL PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"030","type":"MS-DRG"}],"standard_charges":[{"minimum":13482.06,"maximum":60856.51,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":28836.63,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26561,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":33210,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":52410,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":30139,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28087.62,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":28087.62,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":26215.12,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":28087.62,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":18026,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":26482,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":26482,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":27949,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":25278.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":60856.51,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":41121,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":41121,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":13482.06,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":28087.62,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":16692,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":29943,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":22236,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":33265,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":33265,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":28087.62,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":19099.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18725.08,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":19286.84,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":18725.08,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":18725.08,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":18912.34,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":20035.84,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18725.08,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18725.08,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":18116.52,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":22470.1,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":20035.84,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":19661.34,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":19099.59,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0301","type":"APR-DRG"}],"standard_charges":[{"minimum":10209,"maximum":37773.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":10719.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11740.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":28176.84,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10209,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":24501.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10209,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10413.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10413.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37773.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10413.18,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":25012.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37773.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10515.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":10515.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":25216.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10515.27,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0302","type":"APR-DRG"}],"standard_charges":[{"minimum":13452,"maximum":49772.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":14124.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15469.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":37127.52,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13452,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":32284.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13452,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":13721.04,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13721.04,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":49772.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13721.04,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":32957.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":49772.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13855.56,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":13855.56,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":33226.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13855.56,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0303","type":"APR-DRG"}],"standard_charges":[{"minimum":18264,"maximum":67576.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":19177.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21003.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":50408.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18264,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":43833.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18264,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":18629.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18629.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":67576.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18629.28,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":44746.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":67576.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18811.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":18811.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":45112.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18811.92,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0304","type":"APR-DRG"}],"standard_charges":[{"minimum":25583,"maximum":94657.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":26862.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":29420.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":70609.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25583,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":61399.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25583,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":26094.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":26094.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":94657.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":26094.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":62678.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":94657.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":26350.49,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":26350.49,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":63190.01,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":26350.49,"methodology":"case rate"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES WITH MCC","code_information":[{"code":"031","type":"MS-DRG"}],"standard_charges":[{"minimum":24468.48,"maximum":110448,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":52335.36,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":46753,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":62536,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":98693,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":56753,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50976,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":50976,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":47577.6,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":50976,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":33944,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":49868,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":49868,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":52630,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":45878.4,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":110448,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":77434,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":77434,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":24468.48,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":50976,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":29631,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":56385,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":41872,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":62641,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":62641,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":50976,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":34663.68,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":33984,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":35003.52,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":33984,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":33984,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":34323.84,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":36362.88,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":33984,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":33984,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":32879.52,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":40780.8,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":36362.88,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":35683.2,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":34663.68,"methodology":"case rate"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES WITH CC","code_information":[{"code":"032","type":"MS-DRG"}],"standard_charges":[{"minimum":12980.04,"maximum":58590.45,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":27762.86,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":23308,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":31870,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":50296,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":28922,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27041.75,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":27041.75,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":25238.97,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":27041.75,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":17298,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":25414,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":25414,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":26821,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":24337.58,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":58590.45,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":39462,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":39462,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":12980.04,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27041.75,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":15503,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":28734,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":21339,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":31923,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":31923,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":27041.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18388.39,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18027.83,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":18568.67,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":18027.83,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":18027.83,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":18208.11,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":19289.78,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18027.83,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18027.83,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":17441.93,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":21633.4,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":19289.78,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":18929.23,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":18388.39,"methodology":"case rate"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"033","type":"MS-DRG"}],"standard_charges":[{"minimum":9960.62,"maximum":44961.12,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":21304.66,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":19269,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":23810,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":37576,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":21608,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20751.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":20751.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":19367.87,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":20751.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":12924,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":18986,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":18986,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":20038,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":18676.16,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":44961.12,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":29482,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":29482,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":9960.62,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20751.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":11682,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":21467,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":15942,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":23850,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":23850,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":20751.29,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":14110.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13834.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":14249.22,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":13834.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":13834.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":13972.54,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":14802.59,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13834.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13834.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":13384.58,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":16601.03,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":14802.59,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":14525.9,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":14110.88,"methodology":"case rate"}]}]},{"description":"HC HEART SYMP IMAGE PLNR","code_information":[{"code":"0331T","type":"CPT"},{"code":"0340","type":"RC"}],"standard_charges":[{"minimum":2894.4,"maximum":6432,"gross_charge":6432,"discounted_cash":2251.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4502.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4180.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4180.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4502.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4180.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4502.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":6432,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4824,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3216,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":5467.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3537.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3537.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2894.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3537.6,"methodology":"fee schedule"}]}]},{"description":"HC HEART SYMP IMAGE PLNR","code_information":[{"code":"0331T","type":"CPT"},{"code":"0340","type":"RC"}],"standard_charges":[{"minimum":941.46,"maximum":6432,"gross_charge":6432,"discounted_cash":2251.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2013.69,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1641.13,"standard_charge_algorithm": "Lesser of $1641.13 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4020.12,"standard_charge_algorithm": "Lesser of $4020.12 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1526.63,"standard_charge_algorithm": "Lesser of $1526.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":4452.67,"standard_charge_algorithm": "Lesser of $4452.67 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3409.47,"standard_charge_algorithm": "Lesser of $3409.47 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2185.34,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3859.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2251.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2637.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2058.24,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4502.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4180.8,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":1830.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4180.8,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4502.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4180.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4502.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":1765.25,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":6432,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4824,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":4249.67,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":941.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2894.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":5467.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2940,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":2184,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":3268,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3023.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":3268,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3537.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3537.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2327.1,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5314.12,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2637.12,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3537.6,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1333.74,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1346.82,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1320.67,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1399.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1569.11,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.64,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1399.12,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1372.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1333.74,"methodology":"case rate"}]}]},{"description":"HC HEART SYMP IMAGE PLNR SPECT","code_information":[{"code":"0332T","type":"CPT"},{"code":"0340","type":"RC"}],"standard_charges":[{"minimum":3462.75,"maximum":7695,"gross_charge":7695,"discounted_cash":2693.25,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5386.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5001.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5001.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5386.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5001.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5386.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7695,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5771.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3847.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6540.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4232.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4232.25,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3462.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4232.25,"methodology":"fee schedule"}]}]},{"description":"HC HEART SYMP IMAGE PLNR SPECT","code_information":[{"code":"0332T","type":"CPT"},{"code":"0340","type":"RC"}],"standard_charges":[{"minimum":941.46,"maximum":7695,"gross_charge":7695,"discounted_cash":2693.25,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2013.69,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1641.13,"standard_charge_algorithm": "Lesser of $1641.13 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4020.12,"standard_charge_algorithm": "Lesser of $4020.12 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1526.63,"standard_charge_algorithm": "Lesser of $1526.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":4452.67,"standard_charge_algorithm": "Lesser of $4452.67 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3409.47,"standard_charge_algorithm": "Lesser of $3409.47 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2185.34,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":4617,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2693.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3154.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2462.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5386.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5001.75,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":1830.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5001.75,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5386.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5001.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5386.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":1765.25,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7695,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5771.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":4249.67,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":941.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3462.75,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6540.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2940,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":2184,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":3268,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3616.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":3268,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1961.38,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4232.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4232.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2784.06,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6357.61,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3154.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4232.25,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1333.74,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1346.82,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1320.67,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1399.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1307.59,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1569.11,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2077.65,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1399.12,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1372.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1333.74,"methodology":"case rate"}]}]},{"description":"HC TRNSCATH RENAL SYMP DENERV UNI","code_information":[{"code":"0338T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":13746.6,"maximum":30548,"gross_charge":30548,"discounted_cash":10691.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":21383.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":19856.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":19856.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":21383.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":19856.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":21383.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":30548,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":22911,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":15274,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":25965.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":16801.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":16801.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":13746.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":16801.4,"methodology":"fee schedule"}]}]},{"description":"HC TRNSCATH RENAL SYMP DENERV UNI","code_information":[{"code":"0338T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":2670,"maximum":30548,"gross_charge":30548,"discounted_cash":10691.8,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":8794.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":3212,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":2670,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":21383.6,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":4161.28,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":10105.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":4557.6,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":10898.6,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":8273.03,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":8288.48,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":18328.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":8215,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20636,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":7455,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":21383.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":19856.2,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":7995.06,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":19856.2,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":21383.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":19856.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":21383.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":7709.53,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":30548,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":22911,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":18559.97,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":4111.75,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":13746.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":25965.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":14357.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":16801.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":16801.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":11052.27,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":25238.76,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":12524.68,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3360.28,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":4502.78,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3360.28,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":16801.4,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10484.08,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3427.49,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":4603.59,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10484.08,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":5824.98,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":5882.08,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":5767.87,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":6110.51,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":6852.91,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":8247.96,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":6110.51,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":5996.3,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":5824.98,"methodology":"case rate"}]}]},{"description":"HC TCATH RENAL SYMP DENERV BILAT","code_information":[{"code":"0339T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":7717.95,"maximum":17151,"gross_charge":17151,"discounted_cash":6002.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12005.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11148.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11148.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12005.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11148.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12005.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":17151,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":12863.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":8575.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":14578.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9433.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9433.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":7717.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9433.05,"methodology":"fee schedule"}]}]},{"description":"HC TCATH RENAL SYMP DENERV BILAT","code_information":[{"code":"0339T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1886.61,"maximum":20636,"gross_charge":17151,"discounted_cash":6002.85,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":8794.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":3212,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":2670,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":12005.7,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":4161.28,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":10105.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":4557.6,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":10898.6,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":8273.03,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":8288.48,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":10290.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":8215,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20636,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":7455,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12005.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11148.15,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":7995.06,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11148.15,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12005.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11148.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12005.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":7709.53,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":17151,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":12863.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":18559.97,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":4111.75,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7717.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":14578.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":8060.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":8566.14,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9433.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9433.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":6205.24,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14170.16,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":7031.91,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1886.61,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2528.06,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1886.61,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9433.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5886.23,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1924.35,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2584.66,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5886.23,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":5824.98,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":5882.08,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":5767.87,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":6110.51,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":5710.76,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":6852.91,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":4630.77,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":6110.51,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":5996.3,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":5824.98,"methodology":"case rate"}]}]},{"description":"CAROTID ARTERY STENT PROCEDURES WITH MCC","code_information":[{"code":"034","type":"MS-DRG"}],"standard_charges":[{"minimum":22780.72,"maximum":102829.61,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":48725.42,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":45373,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":58031,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":91583,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":52665,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":47459.82,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":47459.82,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":44295.84,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":47459.82,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":31498,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":46276,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":46276,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":48838,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":42713.84,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":102829.61,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":71855,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":71855,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":22780.72,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":47459.82,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":28082,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":52322,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":38856,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":58128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":58128,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":47459.82,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":32272.68,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":31639.88,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":32589.08,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":31639.88,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":31639.88,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":31956.28,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":33854.68,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":31639.88,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":31639.88,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":30611.59,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":37967.86,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":33854.68,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":33221.88,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":32272.68,"methodology":"case rate"}]}]},{"description":"CAROTID ARTERY STENT PROCEDURES WITH CC","code_information":[{"code":"035","type":"MS-DRG"}],"standard_charges":[{"minimum":13758.23,"maximum":62103.12,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":29427.33,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":25910,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":33947,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":53574,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":30808,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28662.98,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":28662.98,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":26752.11,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":28662.98,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":18426,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":27070,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":27070,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":28569,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":25796.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":62103.12,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":42034,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":42034,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":13758.23,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":28662.98,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":16552,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":30607,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":22730,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":34004,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":34004,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":28662.98,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":19490.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":19108.65,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":19681.91,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":19108.65,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":19108.65,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":19299.74,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":20446.26,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":19108.65,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":19108.65,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":18487.62,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":22930.38,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":20446.26,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":20064.09,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":19490.83,"methodology":"case rate"}]}]},{"description":"CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"036","type":"MS-DRG"}],"standard_charges":[{"minimum":11288.92,"maximum":50956.92,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":24145.74,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":21337,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":27355,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":43171,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":24826,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23518.58,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":23518.58,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":21950.67,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":23518.58,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":14848,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":21814,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":21814,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":23022,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":21166.72,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":50956.92,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":33872,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":33872,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":11288.92,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23518.58,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":13015,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":24664,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":18316,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":27401,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":27401,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":23518.58,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15992.64,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15679.05,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":16149.43,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":15679.05,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":15679.05,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":15835.85,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":16776.59,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15679.05,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15679.05,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":15169.49,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":18814.86,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":16776.59,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":16463.01,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":15992.64,"methodology":"case rate"}]}]},{"description":"EXTRACRANIAL PROCEDURES WITH MCC","code_information":[{"code":"037","type":"MS-DRG"}],"standard_charges":[{"minimum":19606.44,"maximum":88501.27,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":41935.99,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":38267,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":49558,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":78211,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":44975,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40846.74,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":40846.74,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":38123.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":40846.74,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":26899,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":39519,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":39519,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":41707,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":36762.07,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":88501.27,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":61364,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":61364,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":19606.44,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40846.74,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":24298,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":44683,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":33182,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":49641,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":49641,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":40846.74,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":27775.79,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":27231.16,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":28048.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":27231.16,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":27231.16,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":27503.48,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":29137.35,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":27231.16,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":27231.16,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":26346.15,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":32677.4,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":29137.35,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":28592.72,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":27775.79,"methodology":"case rate"}]}]},{"description":"EXTRACRANIAL PROCEDURES WITH CC","code_information":[{"code":"038","type":"MS-DRG"}],"standard_charges":[{"minimum":10048.95,"maximum":45359.83,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":21493.58,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":18555,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":24045,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":37948,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":21822,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20935.31,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":20935.31,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":19539.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":20935.31,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":13052,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":19174,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":19174,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":20236,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":18841.78,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":45359.83,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":29774,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":29774,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":10048.95,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20935.31,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":11516,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":21680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":16100,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":24086,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":24086,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":20935.31,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":14236.01,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13956.87,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":14375.58,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":13956.87,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":13956.87,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":14096.44,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":14933.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13956.87,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13956.87,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":13503.28,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":16748.25,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":14933.86,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":14654.72,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":14236.01,"methodology":"case rate"}]}]},{"description":"EXTRACRANIAL PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"039","type":"MS-DRG"}],"standard_charges":[{"minimum":7404.09,"maximum":33421.22,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":15836.52,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13077,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":16985,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":26806,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":15415,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15425.18,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":15425.18,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":14396.83,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":15425.18,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":9219,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":13545,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":13545,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":14295,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":13882.66,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":33421.22,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":21032,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":21032,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":7404.09,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":15425.18,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8213,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":15314,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":11373,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":17014,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":17014,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":15425.18,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10489.12,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10283.45,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":10591.96,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":10283.45,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":10283.45,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":10386.29,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":11003.3,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10283.45,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10283.45,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":9949.24,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":12340.14,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":11003.3,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":10797.63,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":10489.12,"methodology":"case rate"}]}]},{"description":"PERIPHERAL CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC","code_information":[{"code":"040","type":"MS-DRG"}],"standard_charges":[{"minimum":22128.87,"maximum":99887.23,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":47331.18,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":42979,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":56291,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":88837,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":51086,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46101.8,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":46101.8,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":43028.35,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":46101.8,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":30554,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":44888,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":44888,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":47374,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":41491.62,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":99887.23,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":69701,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":69701,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":22128.87,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":46101.8,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":27716,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":50754,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":37691,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":56385,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":56385,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":46101.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":31349.23,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":30734.53,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":31656.57,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":30734.53,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":30734.53,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":31041.88,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":32885.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":30734.53,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":30734.53,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":29735.66,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":36881.44,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":32885.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":32271.26,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":31349.23,"methodology":"case rate"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0401","type":"APR-DRG"}],"standard_charges":[{"minimum":5175,"maximum":19147.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5433.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5951.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":14283,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5175,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12420,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5175,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5278.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5278.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19147.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5278.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12678.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19147.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5330.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5330.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12782.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5330.25,"methodology":"case rate"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0402","type":"APR-DRG"}],"standard_charges":[{"minimum":11160,"maximum":41292,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11718,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12834,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":30801.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11160,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":26784,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11160,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11383.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11383.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":41292,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11383.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":27342,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":41292,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11494.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11494.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":27565.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11494.8,"methodology":"case rate"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0403","type":"APR-DRG"}],"standard_charges":[{"minimum":14447,"maximum":53453.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":15169.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16614.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":39873.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14447,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":34672.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14447,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":14735.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14735.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":53453.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14735.94,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":35395.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":53453.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14880.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":14880.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":35684.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14880.41,"methodology":"case rate"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0404","type":"APR-DRG"}],"standard_charges":[{"minimum":22286,"maximum":82458.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":23400.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25628.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":61509.36,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22286,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":53486.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22286,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22731.72,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22731.72,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":82458.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22731.72,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":54600.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":82458.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22954.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":22954.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":55046.42,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22954.58,"methodology":"case rate"}]}]},{"description":"HC INSJ/RPLC CARDIAC MODULJ SYS","code_information":[{"code":"0408T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":18324.45,"maximum":40721,"gross_charge":40721,"discounted_cash":14252.35,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":28504.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":26468.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26468.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":28504.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":26468.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":28504.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":40721,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":30540.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":20360.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":34612.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22396.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":22396.55,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18324.45,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":22396.55,"methodology":"fee schedule"}]}]},{"description":"HC INSJ/RPLC CARDIAC MODULJ SYS","code_information":[{"code":"0408T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":2670,"maximum":104368.94,"gross_charge":40721,"discounted_cash":14252.35,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":49454.82,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":3212,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":2670,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":28504.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":30947.96,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":19078.83,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":46334.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":20895.86,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":49968.36,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":37930.53,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":38562.79,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":24432.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":28504.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48170.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":48170.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":26468.65,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":44958.93,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26468.65,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":48170.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":28504.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":26468.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":28504.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":43353.25,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":40721,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":30540.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":104368.94,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":23121.73,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":48170.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":18324.45,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":34612.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":13691,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10168,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":15211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":19138.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":15211,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":48170.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22396.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":22396.55,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":14732.86,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33643.7,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":16695.61,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4479.31,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6002.28,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4479.31,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":22396.55,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13975.45,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4568.9,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6136.66,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13975.45,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":32755.79,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":32113.52,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":33076.93,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":32113.52,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":32113.52,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":32434.66,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":34361.47,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":32113.52,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":32113.52,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":32113.52,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":38536.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":10994.67,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":34361.47,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":33719.2,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":32755.79,"methodology":"case rate"}]}]},{"description":"HC INSJ/RPLC CARDIAC MODULJ PLS GN","code_information":[{"code":"0409T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":10571.85,"maximum":23493,"gross_charge":23493,"discounted_cash":8222.55,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":16445.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":15270.45,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":15270.45,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":16445.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":15270.45,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":16445.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":23493,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":17619.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":11746.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":19969.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":12921.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":12921.15,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":10571.85,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":12921.15,"methodology":"fee schedule"}]}]},{"description":"HC INSJ/RPLC CARDIAC MODULJ PLS GN","code_information":[{"code":"0409T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":2584.23,"maximum":73068.29,"gross_charge":23493,"discounted_cash":8222.55,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":34623.13,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":3212,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":2670,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":16445.1,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":17854.68,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":19078.83,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":46334.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":20895.86,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":49968.36,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":37930.53,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":38562.79,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":14095.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":16445.1,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":15270.45,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":31475.57,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":15270.45,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":16445.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":15270.45,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":16445.1,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":30351.44,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":23493,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":17619.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":73068.29,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":16187.44,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":10571.85,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":19969.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":13691,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10168,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":15211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":11041.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":15211,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":12921.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":12921.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":8499.77,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19409.92,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":9632.13,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2584.23,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":3462.87,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2584.23,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":12921.15,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8062.8,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2635.92,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":3540.4,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8062.8,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":22932.2,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":23157.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":22707.38,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":24056.33,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":26979.06,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":6343.11,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":24056.33,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":23606.68,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":22932.2,"methodology":"case rate"}]}]},{"description":"PERIPHERAL CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR","code_information":[{"code":"041","type":"MS-DRG"}],"standard_charges":[{"minimum":13665.43,"maximum":61684.22,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":29228.84,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26526,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":33699,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":53183,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":30583,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28469.64,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":28469.64,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":26571.67,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":28469.64,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":18291,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":26873,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":26873,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":28361,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":25622.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":61684.22,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":41727,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":41727,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":13665.43,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":28469.64,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":16057,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":30384,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":22564,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":33756,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":33756,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":28469.64,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":19359.36,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18979.76,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":19549.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":18979.76,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":18979.76,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":19169.56,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":20308.35,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18979.76,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18979.76,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":18362.92,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":22775.72,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":20308.35,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":19928.75,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":19359.36,"methodology":"case rate"}]}]},{"description":"HC INSJ/RPLC CAR MODULJ ATR ELT","code_information":[{"code":"0410T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":4530.15,"maximum":10067,"gross_charge":10067,"discounted_cash":3523.45,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":10067,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":7550.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":5033.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":8556.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4530.15,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5536.85,"methodology":"fee schedule"}]}]},{"description":"HC INSJ/RPLC CAR MODULJ ATR ELT","code_information":[{"code":"0410T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1107.37,"maximum":26940.52,"gross_charge":10067,"discounted_cash":3523.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":12765.66,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":2038,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1695,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":7650.92,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":6419.15,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":15589.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":7030.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":16812.07,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":12761.89,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13643.65,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":6040.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":11605.15,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11190.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":10067,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":7550.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":26940.52,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5968.36,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4530.15,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":8556.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":4731.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3642.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8317.36,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4127.47,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1107.37,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1483.88,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1107.37,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3455,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1129.52,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1517.1,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3455,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8455.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8538.07,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8372.28,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8869.65,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9947.27,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2718.09,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8869.65,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8703.86,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8455.18,"methodology":"case rate"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0411","type":"APR-DRG"}],"standard_charges":[{"minimum":3859,"maximum":14278.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4051.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4437.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10650.84,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3859,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9261.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3859,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3936.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3936.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14278.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3936.18,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9454.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14278.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3974.77,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3974.77,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9531.73,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3974.77,"methodology":"case rate"}]}]},{"description":"HC INSJ/RPLC CAR MODULJ VNT ELT","code_information":[{"code":"0411T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":4530.15,"maximum":10067,"gross_charge":10067,"discounted_cash":3523.45,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":10067,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":7550.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":5033.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":8556.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4530.15,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5536.85,"methodology":"fee schedule"}]}]},{"description":"HC INSJ/RPLC CAR MODULJ VNT ELT","code_information":[{"code":"0411T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1107.37,"maximum":26940.52,"gross_charge":10067,"discounted_cash":3523.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":12765.66,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":2038,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1695,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":7650.92,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":6419.15,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":15589.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":7030.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":16812.07,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":12761.89,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13643.65,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":6040.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":11605.15,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6543.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":7046.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11190.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":10067,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":7550.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":26940.52,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5968.36,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4530.15,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":8556.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":4731.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12434.08,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3642.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8317.36,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4127.47,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1107.37,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1483.88,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1107.37,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5536.85,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3455,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1129.52,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1517.1,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3455,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8455.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8538.07,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8372.28,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8869.65,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8289.39,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9947.27,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2718.09,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8869.65,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8703.86,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8455.18,"methodology":"case rate"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0412","type":"APR-DRG"}],"standard_charges":[{"minimum":4149,"maximum":15351.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4356.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4771.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11451.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4149,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9957.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4149,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4231.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4231.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15351.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4231.98,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10165.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15351.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4273.47,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4273.47,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10248.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4273.47,"methodology":"case rate"}]}]},{"description":"HC RMVL CARDIAC MODULJ PLS GEN","code_information":[{"code":"0412T","type":"CPT"},{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":2109.15,"maximum":4687,"gross_charge":4687,"discounted_cash":1640.45,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3280.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3046.55,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3046.55,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3280.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3046.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3280.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4687,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3515.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2343.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3983.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2577.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2577.85,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2109.15,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2577.85,"methodology":"fee schedule"}]}]},{"description":"HC RMVL CARDIAC MODULJ PLS GEN","code_information":[{"code":"0412T","type":"CPT"},{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":1265.49,"maximum":20636,"gross_charge":4687,"discounted_cash":1640.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":5613.61,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3280.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":3562.12,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":2506.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":6087.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2745.29,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":6564.82,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":4983.3,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5758.53,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2812.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":8215,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20636,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":7455,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3280.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3046.55,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":5103.28,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3046.55,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3280.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3046.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3280.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":4921.02,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4687,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3515.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":11846.9,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2624.54,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2109.15,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3983.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2202.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2577.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2577.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1695.76,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3872.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1921.67,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2577.85,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":3718.1,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":3754.56,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":3681.65,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3900.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":4374.24,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1265.49,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3900.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3827.46,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":3718.1,"methodology":"case rate"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0413","type":"APR-DRG"}],"standard_charges":[{"minimum":5705,"maximum":21108.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5990.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6560.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":15745.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5705,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":13692,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5705,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5819.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5819.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21108.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5819.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":13977.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21108.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5876.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5876.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":14091.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5876.15,"methodology":"case rate"}]}]},{"description":"HC RMVL CAR MODULJ TRANVNS ELT","code_information":[{"code":"0413T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":4162.95,"maximum":9251,"gross_charge":9251,"discounted_cash":3237.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9251,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6938.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":4625.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7863.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4162.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"}]}]},{"description":"HC RMVL CAR MODULJ TRANVNS ELT","code_information":[{"code":"0413T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1017.61,"maximum":20636,"gross_charge":9251,"discounted_cash":3237.85,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":5613.61,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":7030.76,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":2506.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":6087.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2745.29,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":6564.82,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":4983.3,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5758.53,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":5550.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":8215,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20636,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":7455,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":5103.28,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":4921.02,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9251,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6938.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":11846.9,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2624.54,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4162.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7863.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":4347.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":5467.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3347.02,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7643.18,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3792.91,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1017.61,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1363.6,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1017.61,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3174.95,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1037.97,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1394.13,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3174.95,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":3718.1,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":3754.56,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":3681.65,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3900.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":3645.2,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":4374.24,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2497.77,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3900.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3827.46,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":3718.1,"methodology":"case rate"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0414","type":"APR-DRG"}],"standard_charges":[{"minimum":9792,"maximum":36230.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":10281.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11260.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":27025.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9792,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":23500.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9792,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9987.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9987.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":36230.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9987.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":23990.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":36230.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10085.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":10085.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":24186.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10085.76,"methodology":"case rate"}]}]},{"description":"HC REPOS CAR MODULJ TRANVNS ELT","code_information":[{"code":"0415T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":2352.6,"maximum":5228,"gross_charge":5228,"discounted_cash":1829.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3659.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3398.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3398.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3659.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3398.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3659.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5228,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3921,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2614,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4443.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2875.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2875.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2352.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2875.4,"methodology":"fee schedule"}]}]},{"description":"HC REPOS CAR MODULJ TRANVNS ELT","code_information":[{"code":"0415T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":445.87,"maximum":10059,"gross_charge":5228,"discounted_cash":1829.8,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":953.66,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3659.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":3973.28,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":529.63,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1286.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":580.07,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1387.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":1052.95,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":903.92,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3136.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":4005,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10059,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3635,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3659.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":928.89,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":928.89,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3398.2,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":866.96,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3398.2,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":928.89,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3659.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3398.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3659.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":836,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5228,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3921,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2012.6,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":445.87,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":928.89,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2352.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4443.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2457.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":928.89,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2875.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2875.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1891.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4319.38,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2143.48,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":575.08,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":770.61,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":575.08,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2875.4,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1794.25,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":586.59,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":787.86,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1794.25,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":631.65,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":619.26,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":637.84,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":619.26,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":619.26,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":625.45,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":662.61,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":619.26,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":619.26,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":619.26,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":743.11,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1411.56,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":662.61,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":650.22,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":631.65,"methodology":"case rate"}]}]},{"description":"HC RELOC SKIN POCKET PLS GEN","code_information":[{"code":"0416T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":920.7,"maximum":2046,"gross_charge":2046,"discounted_cash":716.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1432.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1329.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1329.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1432.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1329.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1432.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2046,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1534.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1023,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1739.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1125.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1125.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":920.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1125.3,"methodology":"fee schedule"}]}]},{"description":"HC RELOC SKIN POCKET PLS GEN","code_information":[{"code":"0416T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":225.06,"maximum":12898,"gross_charge":2046,"discounted_cash":716.1,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1432.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1554.96,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1227.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":5135,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12898,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":4660,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1432.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1329.9,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1329.9,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1432.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1329.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1432.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2046,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1534.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":920.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1739.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":961.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1125.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1125.3,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":740.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1690.41,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":838.86,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":225.06,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":301.59,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":225.06,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1125.3,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":702.19,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":229.57,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":308.34,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":702.19,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":552.42,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"HC PRGRMG EVAL CARDIAC MODULJ","code_information":[{"code":"0417T","type":"CPT"},{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":200.25,"maximum":445,"gross_charge":445,"discounted_cash":155.75,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":445,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":333.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":222.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":378.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":200.25,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":244.75,"methodology":"fee schedule"}]}]},{"description":"HC PRGRMG EVAL CARDIAC MODULJ","code_information":[{"code":"0417T","type":"CPT"},{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":26.89,"maximum":1971,"gross_charge":445,"discounted_cash":155.75,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":57.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":42.78,"standard_charge_algorithm": "Lesser of $42.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":112.38,"standard_charge_algorithm": "Lesser of $112.38 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":43.5,"standard_charge_algorithm": "Lesser of $43.50 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":73.23,"standard_charge_algorithm": "Lesser of $73.23 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":77.94,"standard_charge_algorithm": "Lesser of $77.94 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":62.27,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":267,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":52.29,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":50.42,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":445,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":333.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":121.39,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":26.89,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":200.25,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":378.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1773,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1318,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":1971,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":209.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":1971,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":161.01,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":367.66,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":182.45,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":38.1,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":38.47,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":37.72,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":39.96,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":44.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":120.15,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":39.96,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":39.22,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":38.1,"methodology":"case rate"}]}]},{"description":"HC INTERRO EVAL CARDIAC MODULJ","code_information":[{"code":"0418T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":184.95,"maximum":411,"gross_charge":411,"discounted_cash":143.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":411,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":205.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":349.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":184.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":226.05,"methodology":"fee schedule"}]}]},{"description":"HC INTERRO EVAL CARDIAC MODULJ","code_information":[{"code":"0418T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":26.89,"maximum":411,"gross_charge":411,"discounted_cash":143.85,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":57.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":42.78,"standard_charge_algorithm": "Lesser of $42.78 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":112.38,"standard_charge_algorithm": "Lesser of $112.38 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":43.5,"standard_charge_algorithm": "Lesser of $43.50 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":73.23,"standard_charge_algorithm": "Lesser of $73.23 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":77.94,"standard_charge_algorithm": "Lesser of $77.94 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":62.27,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":246.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":52.29,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":50.42,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":411,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":121.39,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":26.89,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":184.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":349.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":193.17,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":56.02,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":148.7,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":339.57,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":168.51,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":45.21,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":60.59,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":45.21,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":141.06,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":46.12,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":61.94,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":141.06,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":38.1,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":38.47,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":37.72,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":39.96,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":37.35,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":44.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":110.97,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":39.96,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":39.22,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":38.1,"methodology":"case rate"}]}]},{"description":"PERIPHERAL CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"042","type":"MS-DRG"}],"standard_charges":[{"minimum":10866.84,"maximum":49051.67,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":23242.95,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":20985,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":26229,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":41393,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":23803,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22639.23,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":22639.23,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":21129.95,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":22639.23,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":14237,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":20915,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":20915,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":22074,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":20375.31,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":49051.67,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":32477,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":32477,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":10866.84,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22639.23,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":12523,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":23649,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":17562,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":26273,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":26273,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":22639.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15394.68,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15092.82,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":15545.61,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":15092.82,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":15092.82,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":15243.75,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":16149.32,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15092.82,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15092.82,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":14602.31,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":18111.39,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":16149.32,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":15847.47,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":15394.68,"methodology":"case rate"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0421","type":"APR-DRG"}],"standard_charges":[{"minimum":3555,"maximum":13153.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3732.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4088.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":9811.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3555,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8532,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3555,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3626.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3626.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13153.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3626.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8709.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13153.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3661.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3661.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8780.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3661.65,"methodology":"case rate"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0422","type":"APR-DRG"}],"standard_charges":[{"minimum":4920,"maximum":18204,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5166,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5658,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":13579.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4920,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11808,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4920,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5018.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5018.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18204,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5018.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12054,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18204,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5067.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5067.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12152.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5067.6,"methodology":"case rate"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0423","type":"APR-DRG"}],"standard_charges":[{"minimum":7732,"maximum":28608.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8118.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8891.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":21340.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7732,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":18556.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7732,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7886.64,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7886.64,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28608.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7886.64,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18943.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28608.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7963.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7963.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":19098.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7963.96,"methodology":"case rate"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0424","type":"APR-DRG"}],"standard_charges":[{"minimum":19157,"maximum":70880.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":20114.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22030.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":52873.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19157,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":45976.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19157,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":19540.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19540.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":70880.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19540.14,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":46934.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":70880.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19731.71,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":19731.71,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":47317.79,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19731.71,"methodology":"case rate"}]}]},{"description":"MULTIPLE SCLEROSIS OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0431","type":"APR-DRG"}],"standard_charges":[{"minimum":4714,"maximum":17441.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4949.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5421.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":13010.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4714,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11313.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4714,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4808.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4808.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17441.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4808.28,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":11549.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17441.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4855.42,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4855.42,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":11643.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4855.42,"methodology":"case rate"}]}]},{"description":"MULTIPLE SCLEROSIS OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0432","type":"APR-DRG"}],"standard_charges":[{"minimum":7011,"maximum":25940.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7361.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8062.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":19350.36,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7011,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":16826.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7011,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7151.22,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7151.22,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":25940.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7151.22,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":17176.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":25940.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7221.33,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7221.33,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":17317.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7221.33,"methodology":"case rate"}]}]},{"description":"MULTIPLE SCLEROSIS OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0433","type":"APR-DRG"}],"standard_charges":[{"minimum":22361,"maximum":82735.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":23479.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25715.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":61716.36,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22361,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":53666.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22361,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22808.22,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22808.22,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":82735.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22808.22,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":54784.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":82735.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23031.83,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":23031.83,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":55231.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23031.83,"methodology":"case rate"}]}]},{"description":"MULTIPLE SCLEROSIS OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0434","type":"APR-DRG"}],"standard_charges":[{"minimum":53730,"maximum":198801,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":56416.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":61789.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":148294.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":53730,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":128952,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":53730,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":54804.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":54804.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":198801,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":54804.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":131638.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":198801,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":55341.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":55341.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":132713.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":55341.9,"methodology":"case rate"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0441","type":"APR-DRG"}],"standard_charges":[{"minimum":4153,"maximum":15366.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4360.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4775.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11462.28,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4153,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9967.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4153,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4236.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4236.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15366.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4236.06,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10174.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15366.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4277.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4277.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10257.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4277.59,"methodology":"case rate"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0442","type":"APR-DRG"}],"standard_charges":[{"minimum":6696,"maximum":24775.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7030.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7700.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":18480.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6696,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":16070.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6696,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6829.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6829.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24775.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6829.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":16405.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24775.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6896.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6896.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16539.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6896.88,"methodology":"case rate"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0443","type":"APR-DRG"}],"standard_charges":[{"minimum":8225,"maximum":30432.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8636.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9458.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":22701,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8225,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":19740,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8225,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":8389.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8389.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":30432.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8389.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":20151.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":30432.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8471.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":8471.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":20315.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8471.75,"methodology":"case rate"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0444","type":"APR-DRG"}],"standard_charges":[{"minimum":12917,"maximum":47792.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":13562.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14854.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":35650.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12917,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":31000.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12917,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":13175.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13175.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":47792.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13175.34,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":31646.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":47792.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13304.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":13304.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":31904.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13304.51,"methodology":"case rate"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0451","type":"APR-DRG"}],"standard_charges":[{"minimum":3899,"maximum":14426.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4093.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4483.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10761.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3899,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9357.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3899,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3976.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3976.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14426.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3976.98,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9552.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14426.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4015.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4015.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9630.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4015.97,"methodology":"case rate"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0452","type":"APR-DRG"}],"standard_charges":[{"minimum":5163,"maximum":19103.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5421.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5937.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":14249.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5163,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12391.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5163,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5266.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5266.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19103.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5266.26,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12649.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19103.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5317.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5317.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12752.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5317.89,"methodology":"case rate"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0453","type":"APR-DRG"}],"standard_charges":[{"minimum":7675,"maximum":28397.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8058.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8826.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":21183,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7675,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":18420,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7675,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7828.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7828.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28397.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7828.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18803.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28397.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7905.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7905.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":18957.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7905.25,"methodology":"case rate"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0454","type":"APR-DRG"}],"standard_charges":[{"minimum":13709,"maximum":50723.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":14394.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15765.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":37836.84,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13709,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":32901.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13709,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":13983.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13983.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":50723.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13983.18,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":33587.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":50723.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14120.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":14120.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":33861.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14120.27,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0461","type":"APR-DRG"}],"standard_charges":[{"minimum":4257,"maximum":15750.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4469.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4895.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11749.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4257,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10216.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4257,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4342.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4342.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15750.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4342.14,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10429.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15750.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4384.71,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4384.71,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10514.79,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4384.71,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0462","type":"APR-DRG"}],"standard_charges":[{"minimum":4292,"maximum":15880.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4506.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4935.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11845.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4292,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10300.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4292,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4377.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4377.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15880.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4377.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10515.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15880.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4420.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4420.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10601.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4420.76,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0463","type":"APR-DRG"}],"standard_charges":[{"minimum":6832,"maximum":25278.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7173.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7856.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":18856.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6832,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":16396.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6832,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6968.64,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6968.64,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":25278.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6968.64,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":16738.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":25278.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7036.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7036.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16875.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7036.96,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0464","type":"APR-DRG"}],"standard_charges":[{"minimum":9080,"maximum":33596,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9534,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10442,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":25060.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9080,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":21792,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9080,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9261.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9261.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33596,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9261.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":22246,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33596,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9352.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9352.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":22427.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9352.4,"methodology":"case rate"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0471","type":"APR-DRG"}],"standard_charges":[{"minimum":3102,"maximum":11477.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3257.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3567.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8561.52,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3102,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7444.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3102,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3164.04,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3164.04,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11477.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3164.04,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7599.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11477.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3195.06,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3195.06,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7661.94,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3195.06,"methodology":"case rate"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0472","type":"APR-DRG"}],"standard_charges":[{"minimum":3901,"maximum":14433.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4096.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4486.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10766.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3901,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9362.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3901,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3979.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3979.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14433.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3979.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9557.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14433.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4018.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4018.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9635.47,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4018.03,"methodology":"case rate"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0473","type":"APR-DRG"}],"standard_charges":[{"minimum":5046,"maximum":18670.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5298.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5802.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":13926.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5046,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12110.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5046,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5146.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5146.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18670.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5146.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12362.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18670.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5197.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5197.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12463.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5197.38,"methodology":"case rate"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0474","type":"APR-DRG"}],"standard_charges":[{"minimum":9250,"maximum":34225,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9712.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10637.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":25530,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9250,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":22200,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9250,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9435,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9435,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":34225,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9435,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":22662.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":34225,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9527.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9527.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":22847.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9527.5,"methodology":"case rate"}]}]},{"description":"PERIPHERAL CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0481","type":"APR-DRG"}],"standard_charges":[{"minimum":3012,"maximum":11144.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3162.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3463.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8313.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3012,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7228.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3012,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3072.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3072.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11144.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3072.24,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7379.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11144.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3102.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3102.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7439.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3102.36,"methodology":"case rate"}]}]},{"description":"PERIPHERAL CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0482","type":"APR-DRG"}],"standard_charges":[{"minimum":3132,"maximum":11588.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3288.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3601.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8644.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3132,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7516.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3132,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3194.64,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3194.64,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11588.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3194.64,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7673.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11588.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3225.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3225.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7736.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3225.96,"methodology":"case rate"}]}]},{"description":"PERIPHERAL CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0483","type":"APR-DRG"}],"standard_charges":[{"minimum":4374,"maximum":16183.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4592.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5030.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":12072.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4374,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10497.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4374,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4461.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4461.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16183.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4461.48,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10716.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16183.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4505.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4505.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10803.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4505.22,"methodology":"case rate"}]}]},{"description":"HC TMVI PERCUTANEOUS APPROACH","code_information":[{"code":"0483T","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":15930.45,"maximum":35401,"gross_charge":35401,"discounted_cash":12390.35,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":24780.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":23010.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":23010.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":24780.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":23010.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":24780.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":35401,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":26550.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":17700.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":30090.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":19470.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":19470.55,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":15930.45,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":19470.55,"methodology":"fee schedule"}]}]},{"description":"HC TMVI PERCUTANEOUS APPROACH","code_information":[{"code":"0483T","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1265.02,"maximum":35401,"gross_charge":35401,"discounted_cash":12390.35,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":24780.7,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":2039.14,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4059.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1737.04,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":4323.73,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":1265.02,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":21240.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":24780.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":23010.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":23010.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":24780.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":23010.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":24780.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":35401,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":26550.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":15930.45,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":30090.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":16638.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":19470.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":19470.55,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":12808.09,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":29248.31,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":14514.41,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3894.11,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5218.11,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3894.11,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":19470.55,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12149.63,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3972,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5334.94,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12149.63,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":9558.27,"methodology":"fee schedule"}]}]},{"description":"PERIPHERAL CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0484","type":"APR-DRG"}],"standard_charges":[{"minimum":18644,"maximum":68982.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":19576.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21440.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":51457.44,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18644,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":44745.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18644,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":19016.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19016.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":68982.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19016.88,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":45677.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":68982.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19203.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":19203.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":46050.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19203.32,"methodology":"case rate"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0491","type":"APR-DRG"}],"standard_charges":[{"minimum":5547,"maximum":20523.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5824.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6379.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":15309.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5547,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":13312.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5547,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5657.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5657.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":20523.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5657.94,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":13590.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":20523.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5713.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5713.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":13701.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5713.41,"methodology":"case rate"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0492","type":"APR-DRG"}],"standard_charges":[{"minimum":11135,"maximum":41199.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11691.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12805.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":30732.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11135,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":26724,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11135,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11357.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11357.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":41199.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11357.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":27280.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":41199.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11469.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11469.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":27503.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11469.05,"methodology":"case rate"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0493","type":"APR-DRG"}],"standard_charges":[{"minimum":11772,"maximum":43556.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":12360.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13537.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":32490.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11772,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":28252.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11772,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":12007.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12007.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":43556.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12007.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":28841.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":43556.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12125.16,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":12125.16,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":29076.84,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12125.16,"methodology":"case rate"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0494","type":"APR-DRG"}],"standard_charges":[{"minimum":24031,"maximum":88914.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":25232.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":27635.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":66325.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24031,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":57674.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":24031,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":24511.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":24511.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":88914.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24511.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":58875.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":88914.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24751.93,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":24751.93,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":59356.57,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":24751.93,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0501","type":"APR-DRG"}],"standard_charges":[{"minimum":2973,"maximum":11000.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3121.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3418.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8205.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2973,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7135.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2973,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3032.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3032.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11000.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3032.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7283.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11000.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3062.19,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3062.19,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7343.31,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3062.19,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0502","type":"APR-DRG"}],"standard_charges":[{"minimum":10089,"maximum":37329.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":10593.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11602.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":27845.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10089,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":24213.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10089,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10290.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10290.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37329.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10290.78,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":24718.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37329.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10391.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":10391.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":24919.83,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10391.67,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0503","type":"APR-DRG"}],"standard_charges":[{"minimum":15655,"maximum":57923.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":16437.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18003.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":43207.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15655,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":37572,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15655,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":15968.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15968.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":57923.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15968.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":38354.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":57923.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16124.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":16124.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":38667.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":16124.65,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0504","type":"APR-DRG"}],"standard_charges":[{"minimum":30771,"maximum":113852.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":32309.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":35386.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":84927.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":30771,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":73850.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":30771,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":31386.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":31386.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":113852.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":31386.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":75388.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":113852.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":31694.13,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":31694.13,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":76004.37,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":31694.13,"methodology":"case rate"}]}]},{"description":"HC EV FEMPOP ARTL REVAS","code_information":[{"code":"0505T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":11481.75,"maximum":25515,"gross_charge":25515,"discounted_cash":8930.25,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":17860.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":16584.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":16584.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":17860.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":16584.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":17860.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":25515,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":19136.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":12757.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":21687.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":14033.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":14033.25,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":11481.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":14033.25,"methodology":"fee schedule"}]}]},{"description":"HC EV FEMPOP ARTL REVAS","code_information":[{"code":"0505T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1695,"maximum":36916.56,"gross_charge":25515,"discounted_cash":8930.25,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":17492.77,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":2038,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1695,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":17860.5,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":8323.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":20213.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":9115.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":21798.66,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":16547.16,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":16797.53,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":15309,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":17860.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":16584.75,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":15902.52,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":16584.75,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":17860.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":16584.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":17860.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":15334.57,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":25515,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":19136.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":36916.56,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8178.44,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":11481.75,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":21687.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":11992.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":17038.41,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":14033.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":14033.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":9231.33,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21080.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":10461.15,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2806.65,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":3760.92,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2806.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":14033.25,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8756.75,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2862.79,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":3845.12,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8756.75,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11586.12,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":11699.71,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":11472.53,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":12154.07,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11358.94,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":13630.73,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":6889.05,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":12154.07,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":11926.89,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":11586.12,"methodology":"case rate"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0511","type":"APR-DRG"}],"standard_charges":[{"minimum":2040,"maximum":7548,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2142,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2346,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":5630.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2040,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2040,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2080.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2080.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7548,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2080.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":4998,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7548,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2101.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2101.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5038.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2101.2,"methodology":"case rate"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0512","type":"APR-DRG"}],"standard_charges":[{"minimum":3321,"maximum":12287.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3487.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3819.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":9165.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3321,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7970.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3321,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3387.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3387.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12287.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3387.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8136.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12287.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3420.63,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3420.63,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8202.87,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3420.63,"methodology":"case rate"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0513","type":"APR-DRG"}],"standard_charges":[{"minimum":4792,"maximum":17730.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5031.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5510.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":13225.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4792,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11500.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4792,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4887.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4887.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17730.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4887.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":11740.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17730.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4935.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4935.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":11836.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4935.76,"methodology":"case rate"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0514","type":"APR-DRG"}],"standard_charges":[{"minimum":14255,"maximum":52743.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":14967.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16393.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":39343.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14255,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":34212,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14255,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":14540.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14540.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":52743.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14540.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":34924.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":52743.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14682.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":14682.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":35209.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14682.65,"methodology":"case rate"}]}]},{"description":"HC NSJ WCS LV COMPL SYS","code_information":[{"code":"0515T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":24177.6,"maximum":53728,"gross_charge":53728,"discounted_cash":18804.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":37609.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":34923.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":34923.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":37609.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":34923.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":37609.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":53728,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":40296,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":26864,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":45668.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":29550.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":29550.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":24177.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":29550.4,"methodology":"fee schedule"}]}]},{"description":"HC NSJ WCS LV COMPL SYS","code_information":[{"code":"0515T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1695,"maximum":73068.29,"gross_charge":53728,"discounted_cash":18804.8,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":34623.13,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":2038,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1695,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":37609.6,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":19078.83,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":46334.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":20895.86,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":49968.36,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":37930.53,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":38562.79,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":32236.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":37609.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":34923.2,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":31475.57,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":34923.2,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":37609.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":34923.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":37609.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":30351.44,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":53728,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":40296,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":73068.29,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":16187.44,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":24177.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":45668.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":13691,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10168,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":15211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":25252.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":15211,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":33723.82,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":29550.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":29550.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":19438.8,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":44390.08,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":22028.48,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5910.08,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7919.51,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5910.08,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":29550.4,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18439.45,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6028.29,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8096.81,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18439.45,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":22932.2,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":23157.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":22707.38,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":24056.33,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":22482.55,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":26979.06,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":14506.56,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":24056.33,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":23606.68,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":22932.2,"methodology":"case rate"}]}]},{"description":"HC INSJ WCS LV ELTRD ONLY","code_information":[{"code":"0516T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":8135.1,"maximum":18078,"gross_charge":18078,"discounted_cash":6327.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12654.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11750.7,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11750.7,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12654.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11750.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12654.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":18078,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":13558.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":9039,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":15366.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9942.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9942.9,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":8135.1,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9942.9,"methodology":"fee schedule"}]}]},{"description":"HC INSJ WCS LV ELTRD ONLY","code_information":[{"code":"0516T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1695,"maximum":34067.41,"gross_charge":18078,"discounted_cash":6327.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":16142.71,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":2038,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1695,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":12654.6,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":6419.15,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":15589.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":7030.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":16812.07,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":12761.89,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13643.65,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":10846.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":12654.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15723.42,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":15723.42,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":11750.7,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":14675.19,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11750.7,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":15723.42,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":12654.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":11750.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":12654.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":14151.08,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":18078,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":13558.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":34067.41,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":7547.24,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":15723.42,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8135.1,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":15366.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":8496.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":15723.42,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9942.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":9942.9,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":6540.63,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14936.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":7411.98,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1988.58,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2664.7,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1988.58,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":9942.9,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6204.37,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2028.36,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2724.36,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6204.37,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10691.93,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10482.28,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":10796.75,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":10482.28,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":10482.28,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":10587.1,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":11216.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10482.28,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10482.28,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":10482.28,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":12578.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":4881.06,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":11216.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":11006.39,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":10691.93,"methodology":"case rate"}]}]},{"description":"SPINAL DISORDERS AND INJURIES WITH CC/MCC","code_information":[{"code":"052","type":"MS-DRG"}],"standard_charges":[{"minimum":12291.85,"maximum":55484.04,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":26290.9,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":20198,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":30033,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":47396,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":27255,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25608.02,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":25608.02,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":23900.82,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":25608.02,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":16301,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":23949,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":23949,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":25275,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":23047.22,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":55484.04,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":37187,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":37187,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":12291.85,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25608.02,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":13996,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":27078,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":20109,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":30083,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":30083,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":25608.02,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":17413.46,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":17072.01,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":17584.18,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":17072.01,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":17072.01,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":17242.74,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":18267.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":17072.01,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":17072.01,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":16517.17,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":20486.42,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":18267.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":17925.62,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":17413.46,"methodology":"case rate"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0521","type":"APR-DRG"}],"standard_charges":[{"minimum":2858,"maximum":10574.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3000.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3286.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":7888.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2858,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6859.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2858,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2915.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2915.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10574.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2915.16,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7002.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10574.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2943.74,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2943.74,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7059.26,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2943.74,"methodology":"case rate"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0522","type":"APR-DRG"}],"standard_charges":[{"minimum":3671,"maximum":13582.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3854.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4221.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10131.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3671,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8810.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3671,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3744.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3744.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13582.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3744.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8993.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13582.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3781.13,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3781.13,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9067.37,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3781.13,"methodology":"case rate"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0523","type":"APR-DRG"}],"standard_charges":[{"minimum":4670,"maximum":17279,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4903.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5370.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":12889.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4670,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11208,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4670,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4763.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4763.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17279,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4763.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":11441.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17279,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4810.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4810.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":11534.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4810.1,"methodology":"case rate"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0524","type":"APR-DRG"}],"standard_charges":[{"minimum":12639,"maximum":46764.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":13270.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14534.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":34883.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12639,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":30333.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12639,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":12891.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12891.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":46764.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12891.78,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":30965.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":46764.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13018.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":13018.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":31218.33,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13018.17,"methodology":"case rate"}]}]},{"description":"SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC","code_information":[{"code":"053","type":"MS-DRG"}],"standard_charges":[{"minimum":6192.08,"maximum":27950.33,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":13244.16,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11604,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":13750,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21700,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":12479,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12900.15,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12900.15,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":12040.14,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12900.15,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":7463,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":10965,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":10965,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":11572,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11610.14,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":27950.33,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":17026,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":17026,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6192.08,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12900.15,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7081,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":12397,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":9207,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":13773,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":13773,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12900.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8772.11,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8600.1,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8858.11,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8600.1,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8600.1,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8686.11,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":9202.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8600.1,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8600.1,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8320.6,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":10320.12,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":9202.11,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":9030.11,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8772.11,"methodology":"case rate"}]}]},{"description":"SEIZURE","code_information":[{"code":"0531","type":"APR-DRG"}],"standard_charges":[{"minimum":2388,"maximum":8835.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2507.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2746.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6590.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2388,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5731.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2388,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2435.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2435.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8835.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2435.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5850.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8835.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2459.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2459.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5898.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2459.64,"methodology":"case rate"}]}]},{"description":"SEIZURE","code_information":[{"code":"0532","type":"APR-DRG"}],"standard_charges":[{"minimum":3211,"maximum":11880.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3371.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3692.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8862.36,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3211,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7706.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3211,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3275.22,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3275.22,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11880.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3275.22,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7866.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11880.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3307.33,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3307.33,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7931.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3307.33,"methodology":"case rate"}]}]},{"description":"SEIZURE","code_information":[{"code":"0533","type":"APR-DRG"}],"standard_charges":[{"minimum":4647,"maximum":17193.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4879.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5344.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":12825.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4647,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11152.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4647,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4739.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4739.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17193.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4739.94,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":11385.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17193.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4786.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4786.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":11478.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4786.41,"methodology":"case rate"}]}]},{"description":"SEIZURE","code_information":[{"code":"0534","type":"APR-DRG"}],"standard_charges":[{"minimum":10822,"maximum":40041.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11363.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12445.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":29868.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10822,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":25972.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10822,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11038.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11038.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":40041.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11038.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":26513.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":40041.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11146.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11146.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":26730.34,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11146.66,"methodology":"case rate"}]}]},{"description":"NERVOUS SYSTEM NEOPLASMS WITH MCC","code_information":[{"code":"054","type":"MS-DRG"}],"standard_charges":[{"minimum":9421.69,"maximum":42528.46,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":20151.95,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":15736,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":22371,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":35305,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":20302,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19628.52,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":19628.52,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":18319.96,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":19628.52,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":12143,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":17839,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":17839,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":18827,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":17665.67,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":42528.46,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":27700,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":27700,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":9421.69,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19628.52,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":10606,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":20170,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":14979,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":22409,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":22409,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":19628.52,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13347.4,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13085.68,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":13478.26,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":13085.68,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":13085.68,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":13216.54,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":14001.68,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13085.68,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13085.68,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":12660.4,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":15702.82,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":14001.68,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":13739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":13347.4,"methodology":"case rate"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0541","type":"APR-DRG"}],"standard_charges":[{"minimum":2717,"maximum":10052.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2852.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3124.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":7498.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2717,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6520.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2717,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2771.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2771.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10052.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2771.34,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6656.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10052.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2798.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2798.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":6710.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2798.51,"methodology":"case rate"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0542","type":"APR-DRG"}],"standard_charges":[{"minimum":3394,"maximum":12557.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3563.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3903.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":9367.44,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3394,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8145.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3394,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3461.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3461.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12557.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3461.88,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8315.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12557.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3495.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3495.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8383.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3495.82,"methodology":"case rate"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0543","type":"APR-DRG"}],"standard_charges":[{"minimum":4323,"maximum":15995.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4539.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4971.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11931.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4323,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10375.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4323,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4409.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4409.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15995.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4409.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10591.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15995.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4452.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4452.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10677.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4452.69,"methodology":"case rate"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0544","type":"APR-DRG"}],"standard_charges":[{"minimum":9665,"maximum":35760.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":10148.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11114.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":26675.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9665,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":23196,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9665,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9858.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9858.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":35760.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9858.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":23679.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":35760.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9954.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9954.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":23872.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9954.95,"methodology":"case rate"}]}]},{"description":"NERVOUS SYSTEM NEOPLASMS WITHOUT MCC","code_information":[{"code":"055","type":"MS-DRG"}],"standard_charges":[{"minimum":7140.22,"maximum":32230.16,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":15272.14,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11439,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":16281,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25694,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":14775,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14875.46,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":14875.46,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":13883.76,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":14875.46,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":8837,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":12983,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":12983,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":13702,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":13387.91,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":32230.16,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":20159,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":20159,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":7140.22,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14875.46,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7725,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":14679,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10901,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":16308,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":16308,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":14875.46,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10115.31,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9916.97,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":10214.48,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":9916.97,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":9916.97,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":10016.14,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":10611.16,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9916.97,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9916.97,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":9594.67,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":11900.37,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":10611.16,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":10412.82,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":10115.31,"methodology":"case rate"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0551","type":"APR-DRG"}],"standard_charges":[{"minimum":2925,"maximum":10822.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3071.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3363.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8073,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2925,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7020,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2925,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2983.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2983.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10822.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2983.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7166.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10822.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3012.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3012.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7224.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3012.75,"methodology":"case rate"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0552","type":"APR-DRG"}],"standard_charges":[{"minimum":4953,"maximum":18326.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5200.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5695.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":13670.28,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4953,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11887.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4953,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5052.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5052.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18326.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5052.06,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12134.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18326.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5101.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5101.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12233.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5101.59,"methodology":"case rate"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0553","type":"APR-DRG"}],"standard_charges":[{"minimum":7450,"maximum":27565,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7822.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8567.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":20562,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7450,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":17880,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7450,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7599,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7599,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27565,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7599,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18252.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27565,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7673.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7673.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":18401.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7673.5,"methodology":"case rate"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0554","type":"APR-DRG"}],"standard_charges":[{"minimum":13500,"maximum":49950,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":14175,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15525,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":37260,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13500,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":32400,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13500,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":13770,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13770,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":49950,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13770,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":33075,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":49950,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13905,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":13905,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":33345,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13905,"methodology":"case rate"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC","code_information":[{"code":"056","type":"MS-DRG"}],"standard_charges":[{"minimum":15040.14,"maximum":67889.48,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":32169.17,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":25308,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":37369,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":58974,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":33913,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31333.61,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":31333.61,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":29244.7,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":31333.61,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":20283,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":29799,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":29799,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":31449,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":28200.25,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":67889.48,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":46271,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":46271,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":15040.14,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":31333.61,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":17232,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":33693,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":25021,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":37431,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":37431,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":31333.61,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":21306.86,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20889.07,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":21515.75,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":20889.07,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":20889.07,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":21097.97,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":22351.31,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":20889.07,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20889.07,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":20210.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":25066.89,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":22351.31,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":21933.53,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":21306.86,"methodology":"case rate"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0561","type":"APR-DRG"}],"standard_charges":[{"minimum":3640,"maximum":13468,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3822,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4186,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10046.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3640,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8736,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3640,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3712.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3712.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13468,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3712.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8918,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13468,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3749.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3749.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8990.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3749.2,"methodology":"case rate"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0562","type":"APR-DRG"}],"standard_charges":[{"minimum":5133,"maximum":18992.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5389.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5902.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":14167.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5133,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12319.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5133,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5235.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5235.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18992.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5235.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12575.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18992.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5286.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5286.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12678.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5286.99,"methodology":"case rate"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0563","type":"APR-DRG"}],"standard_charges":[{"minimum":7841,"maximum":29011.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8233.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9017.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":21641.16,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7841,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":18818.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7841,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7997.82,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7997.82,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":29011.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7997.82,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":19210.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":29011.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8076.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":8076.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":19367.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8076.23,"methodology":"case rate"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0564","type":"APR-DRG"}],"standard_charges":[{"minimum":15051,"maximum":55688.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":15803.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":17308.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":41540.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15051,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":36122.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15051,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":15352.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15352.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":55688.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15352.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":36874.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":55688.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15502.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":15502.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":37175.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15502.53,"methodology":"case rate"}]}]},{"description":"HC TTVR PERQ APPR 1ST PROSTH","code_information":[{"code":"0569T","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":12760.65,"maximum":28357,"gross_charge":28357,"discounted_cash":9924.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":19849.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":18432.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":18432.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":19849.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":18432.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":19849.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":28357,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":21267.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":14178.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":24103.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":15596.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":15596.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":12760.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":15596.35,"methodology":"fee schedule"}]}]},{"description":"HC TTVR PERQ APPR 1ST PROSTH","code_information":[{"code":"0569T","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":724.3,"maximum":28357,"gross_charge":28357,"discounted_cash":9924.95,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":19849.9,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1167.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2324.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":994.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":2475.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":724.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":17014.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":19849.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":18432.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":18432.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":19849.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":18432.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":19849.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":28357,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":21267.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":12760.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":24103.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":13327.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":15596.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":15596.35,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":10259.57,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23428.56,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":11626.37,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3119.27,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":4179.83,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3119.27,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":15596.35,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":9732.13,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3181.66,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":4273.4,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":9732.13,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":7656.39,"methodology":"fee schedule"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC","code_information":[{"code":"057","type":"MS-DRG"}],"standard_charges":[{"minimum":8500.94,"maximum":38372.3,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":18182.57,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":14766,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":19913,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":31426,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":18072,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17710.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":17710.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":16529.61,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":17710.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":10809,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":15879,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":15879,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":16759,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":15939.27,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":38372.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":24657,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":24657,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8500.94,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17710.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":9812,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":17954,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":13333,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":19947,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":19947,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":17710.29,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12043,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11806.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":12161.07,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":11806.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":11806.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":11924.93,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":12633.35,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11806.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11806.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11423.14,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":14168.24,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":12633.35,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":12397.21,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":12043,"methodology":"case rate"}]}]},{"description":"HC TTVR PERQ EA ADDL PROSTH","code_information":[{"code":"0570T","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":6379.65,"maximum":14177,"gross_charge":14177,"discounted_cash":4961.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":9923.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":9215.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9215.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":9923.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":9215.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":9923.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":14177,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":10632.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":7088.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":12050.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7797.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":7797.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":6379.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":7797.35,"methodology":"fee schedule"}]}]},{"description":"HC TTVR PERQ EA ADDL PROSTH","code_information":[{"code":"0570T","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":724.3,"maximum":14177,"gross_charge":14177,"discounted_cash":4961.95,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":9923.9,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1167.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2324.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":994.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":2475.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":724.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":8506.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":9923.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":9215.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9215.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":9923.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":9215.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":9923.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":14177,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":10632.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6379.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":12050.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":6663.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7797.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":7797.35,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":5129.24,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11713.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":5812.57,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1559.47,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2089.69,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1559.47,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":7797.35,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4865.55,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1590.66,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2136.48,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4865.55,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":3827.79,"methodology":"fee schedule"}]}]},{"description":"CONCUSSION CLOSED SKULL FRACTURE NOS AND UNCOMPLICATED INTRACRANIAL INJURY COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0571","type":"APR-DRG"}],"standard_charges":[{"minimum":2200,"maximum":8140,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2310,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2530,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6072,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2200,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5280,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2200,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2244,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2244,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8140,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2244,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5390,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8140,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2266,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2266,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5434,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2266,"methodology":"case rate"}]}]},{"description":"CONCUSSION CLOSED SKULL FRACTURE NOS AND UNCOMPLICATED INTRACRANIAL INJURY COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0572","type":"APR-DRG"}],"standard_charges":[{"minimum":3885,"maximum":14374.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4079.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4467.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10722.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3885,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9324,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3885,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3962.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3962.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14374.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3962.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9518.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14374.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4001.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4001.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9595.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4001.55,"methodology":"case rate"}]}]},{"description":"CONCUSSION CLOSED SKULL FRACTURE NOS AND UNCOMPLICATED INTRACRANIAL INJURY COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0573","type":"APR-DRG"}],"standard_charges":[{"minimum":7422,"maximum":27461.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7793.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8535.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":20484.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7422,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":17812.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7422,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7570.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7570.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27461.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7570.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18183.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27461.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7644.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7644.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":18332.34,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7644.66,"methodology":"case rate"}]}]},{"description":"CONCUSSION CLOSED SKULL FRACTURE NOS AND UNCOMPLICATED INTRACRANIAL INJURY COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0574","type":"APR-DRG"}],"standard_charges":[{"minimum":18527,"maximum":68549.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":19453.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21306.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":51134.52,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18527,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":44464.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18527,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":18897.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18897.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":68549.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18897.54,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":45391.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":68549.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19082.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":19082.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":45761.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19082.81,"methodology":"case rate"}]}]},{"description":"MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC","code_information":[{"code":"058","type":"MS-DRG"}],"standard_charges":[{"minimum":11360.47,"maximum":51279.9,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":24298.79,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":19574,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":27546,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":43473,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":24999,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23667.65,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":23667.65,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":22089.81,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":23667.65,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":14952,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":21966,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":21966,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":23183,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":21300.89,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":51279.9,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":34109,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":34109,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":11360.47,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23667.65,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":12437,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":24837,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":18444,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":27593,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":27593,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":23667.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":16094,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15778.43,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":16251.79,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":15778.43,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":15778.43,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":15936.22,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":16882.93,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15778.43,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15778.43,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":15265.64,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":18934.12,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":16882.93,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":16567.36,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":16094,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0581","type":"APR-DRG"}],"standard_charges":[{"minimum":4010,"maximum":14837,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4210.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4611.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11067.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4010,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9624,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4010,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4090.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4090.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14837,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4090.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9824.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14837,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4130.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9904.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4130.3,"methodology":"case rate"}]}]},{"description":"HC PERQ BRST TUMR CRYOTHRPY/UNI","code_information":[{"code":"0581T","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":4815,"maximum":10700,"gross_charge":10700,"discounted_cash":3745,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":7490,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6955,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6955,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":7490,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6955,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":7490,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":10700,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":8025,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":5350,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":9095,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5885,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5885,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4815,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5885,"methodology":"fee schedule"}]}]},{"description":"HC PERQ BRST TUMR CRYOTHRPY/UNI","code_information":[{"code":"0581T","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":724.3,"maximum":12465.31,"gross_charge":10700,"discounted_cash":3745,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":5906.64,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":2038,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1695,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":7490,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1167.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2324.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":994.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":2475.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":724.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":6420,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":7490,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5753.22,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":5753.22,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6955,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":5369.67,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6955,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":5753.22,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":7490,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6955,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":7490,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":5177.9,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":10700,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":8025,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":12465.31,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2761.55,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5753.22,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4815,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":9095,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":5029,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":5753.22,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5885,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5885,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3871.26,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8840.34,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4387,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5885,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":3912.19,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":3835.48,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":3950.54,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":3835.48,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":3835.48,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":3873.83,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":4103.96,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":3835.48,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":3835.48,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":3835.48,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":4602.58,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2889,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":4103.96,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":4027.25,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":3912.19,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0582","type":"APR-DRG"}],"standard_charges":[{"minimum":5676,"maximum":21001.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5959.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6527.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":15665.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5676,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":13622.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5676,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5789.52,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5789.52,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21001.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5789.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":13906.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21001.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5846.28,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5846.28,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":14019.72,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5846.28,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0583","type":"APR-DRG"}],"standard_charges":[{"minimum":9094,"maximum":33647.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9548.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10458.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":25099.44,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9094,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":21825.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9094,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9275.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9275.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33647.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9275.88,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":22280.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33647.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9366.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9366.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":22462.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9366.82,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0584","type":"APR-DRG"}],"standard_charges":[{"minimum":18378,"maximum":67998.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":19296.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21134.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":50723.28,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18378,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":44107.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18378,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":18745.56,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18745.56,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":67998.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18745.56,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":45026.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":67998.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18929.34,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":18929.34,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":45393.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18929.34,"methodology":"case rate"}]}]},{"description":"MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC","code_information":[{"code":"059","type":"MS-DRG"}],"standard_charges":[{"minimum":7881.52,"maximum":35576.29,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":16857.69,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":12973,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":18260,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":28817,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":16571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16419.83,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":16419.83,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":15325.17,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":16419.83,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":9911,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":14561,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":14561,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":15367,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":14777.85,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":35576.29,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":22610,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":22610,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":7881.52,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16419.83,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8545,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":16464,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":12226,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":18290,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":18290,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":16419.83,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11165.49,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10946.55,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":11274.95,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":10946.55,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":10946.55,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":11056.02,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":11712.81,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10946.55,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10946.55,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":10590.79,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":13135.86,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":11712.81,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":11493.88,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":11165.49,"methodology":"case rate"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0591","type":"APR-DRG"}],"standard_charges":[{"minimum":6515,"maximum":24105.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6840.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7492.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":17981.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6515,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":15636,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6515,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6645.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6645.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24105.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6645.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":15961.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24105.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6710.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6710.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16092.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6710.45,"methodology":"case rate"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0592","type":"APR-DRG"}],"standard_charges":[{"minimum":8074,"maximum":29873.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8477.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9285.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":22284.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8074,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":19377.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8074,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":8235.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8235.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":29873.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8235.48,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":19781.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":29873.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8316.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":8316.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":19942.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8316.22,"methodology":"case rate"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0593","type":"APR-DRG"}],"standard_charges":[{"minimum":12142,"maximum":44925.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":12749.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13963.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":33511.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12142,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":29140.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12142,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":12384.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12384.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":44925.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12384.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":29747.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":44925.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12506.26,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":12506.26,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":29990.74,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12506.26,"methodology":"case rate"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0594","type":"APR-DRG"}],"standard_charges":[{"minimum":21021,"maximum":77777.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":22072.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24174.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":58017.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21021,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":50450.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21021,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":21441.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21441.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":77777.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21441.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":51501.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":77777.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21651.63,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":21651.63,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":51921.87,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21651.63,"methodology":"case rate"}]}]},{"description":"MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC","code_information":[{"code":"060","type":"MS-DRG"}],"standard_charges":[{"minimum":6029.95,"maximum":27218.49,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":12897.38,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":10282,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":13317,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21017,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":12086,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12562.38,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12562.38,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":11724.89,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12562.38,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":7228,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":10620,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":10620,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":11208,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11306.15,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":27218.49,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":16490,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":16490,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6029.95,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12562.38,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6459,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":12007,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":8917,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":13340,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":13340,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12562.38,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8542.42,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8374.92,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8626.17,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8374.92,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8374.92,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8458.67,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8961.17,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8374.92,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8374.92,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8102.74,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":10049.91,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8961.17,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8793.67,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8542.42,"methodology":"case rate"}]}]},{"description":"ISCHEMIC STROKE PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC","code_information":[{"code":"061","type":"MS-DRG"}],"standard_charges":[{"minimum":16154.32,"maximum":72918.79,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":34552.29,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":33270,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":40343,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":63668,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":36612,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33654.83,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":33654.83,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":31411.17,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":33654.83,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":21898,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":32170,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":32170,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":33952,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":30289.35,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":72918.79,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":49953,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":49953,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":16154.32,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":33654.83,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":20174,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":36374,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":27012,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":40410,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":40410,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":33654.83,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":22885.29,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":22436.55,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":23109.65,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":22436.55,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":22436.55,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":22660.92,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":24007.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":22436.55,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":22436.55,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":21707.37,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":26923.86,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":24007.11,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":23558.38,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":22885.29,"methodology":"case rate"}]}]},{"description":"HC PERQ TCAT INTRATRL SEPTL SHT","code_information":[{"code":"0613T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":14841.9,"maximum":32982,"gross_charge":32982,"discounted_cash":11543.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":23087.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":21438.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":21438.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":23087.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":21438.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":23087.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":32982,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":24736.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":16491,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":28034.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":18140.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":18140.1,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":14841.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":18140.1,"methodology":"fee schedule"}]}]},{"description":"HC PERQ TCAT INTRATRL SEPTL SHT","code_information":[{"code":"0613T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1848.58,"maximum":32982,"gross_charge":32982,"discounted_cash":11543.7,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":23087.4,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":2216.13,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4280.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1848.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":4778.2,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3102.58,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":19789.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":23087.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":21438.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":21438.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":23087.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":21438.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":23087.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":32982,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":24736.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":14841.9,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":28034.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":15501.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":18140.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":18140.1,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":11932.89,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27249.73,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":13522.62,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3628.02,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":4861.55,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3628.02,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":18140.1,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11319.43,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3700.59,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":4970.39,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11319.43,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":8905.14,"methodology":"fee schedule"}]}]},{"description":"ISCHEMIC STROKE PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC","code_information":[{"code":"062","type":"MS-DRG"}],"standard_charges":[{"minimum":10997.1,"maximum":49639.66,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":23521.56,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":21751,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":26576,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":41942,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":24119,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22910.61,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":22910.61,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":21383.24,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":22910.61,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":14425,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":21193,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":21193,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":22366,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":20619.55,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":49639.66,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":32907,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":32907,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":10997.1,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22910.61,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":13472,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":23962,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":17795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":26621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":26621,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":22910.61,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15579.22,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15273.74,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":15731.96,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":15273.74,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":15273.74,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":15426.48,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":16342.91,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15273.74,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15273.74,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":14777.35,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":18328.49,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":16342.91,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":16037.43,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":15579.22,"methodology":"case rate"}]}]},{"description":"HC EVASC VEN ARTLZ TIBL/PRNL VN","code_information":[{"code":"0620T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":30598.2,"maximum":67996,"gross_charge":67996,"discounted_cash":23798.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":47597.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":44197.4,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":44197.4,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":47597.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":44197.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":47597.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":67996,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":50997,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":33998,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":57796.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":37397.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":37397.8,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":30598.2,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":37397.8,"methodology":"fee schedule"}]}]},{"description":"HC EVASC VEN ARTLZ TIBL/PRNL VN","code_information":[{"code":"0620T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":1695,"maximum":113935.9,"gross_charge":67996,"discounted_cash":23798.6,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":53988.09,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":2038,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1695,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":47597.2,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":13493.76,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":32770.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":14778.88,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":35340.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":26826.88,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26857.58,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":40797.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":47597.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":52585.8,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":52585.8,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":44197.4,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":49080.08,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":44197.4,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":52585.8,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":47597.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":44197.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":47597.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":47327.22,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":67996,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":50997,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":113935.9,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":25241.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":52585.8,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":30598.2,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":57796.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":31958.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":52585.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":37397.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":37397.8,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":24600.96,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":56178.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":27878.36,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7479.56,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10022.62,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7479.56,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":37397.8,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23336.23,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7629.16,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10247,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23336.23,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":35758.34,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":35057.2,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":36108.92,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":35057.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":35057.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":35407.77,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":37511.2,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":35057.2,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":35057.2,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":35057.2,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":42068.64,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":18358.92,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":37511.2,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":36810.06,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":35758.34,"methodology":"case rate"}]}]},{"description":"ISCHEMIC STROKE PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC","code_information":[{"code":"063","type":"MS-DRG"}],"standard_charges":[{"minimum":8894.52,"maximum":40148.85,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":19024.38,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":17936,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":20964,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":33084,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":19025,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18530.24,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":18530.24,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":17294.89,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":18530.24,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":11379,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":16717,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":16717,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":17643,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":16677.22,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":40148.85,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":25958,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":25958,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8894.52,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18530.24,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":10702,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":18902,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":14037,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":20999,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":20999,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":18530.24,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12600.56,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12353.49,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":12724.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":12353.49,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":12353.49,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":12477.03,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":13218.24,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12353.49,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12353.49,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11952.01,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":14824.19,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":13218.24,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":12971.17,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":12600.56,"methodology":"case rate"}]}]},{"description":"HC PERQ TCAT US ABLTJ NRV P-ART","code_information":[{"code":"0632T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":18589.35,"maximum":41309.65,"gross_charge":41309.65,"discounted_cash":14458.38,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":41309.65,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":30982.24,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":20654.83,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":35113.21,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18589.35,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":22720.31,"methodology":"fee schedule"}]}]},{"description":"HC PERQ TCAT US ABLTJ NRV P-ART","code_information":[{"code":"0632T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":2670,"maximum":58453.88,"gross_charge":41309.65,"discounted_cash":14458.38,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":27698.15,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":3212,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":2670,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":6375.05,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":12314.73,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":5317.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":13745.23,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":8925.07,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26857.58,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":24785.79,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":25180.13,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":24280.84,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":41309.65,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":30982.24,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":58453.88,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":12949.78,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":18589.35,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":35113.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":5621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":4175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":19415.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":6245,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":26978.72,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":14945.84,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":34130.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":16936.96,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4544.07,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6089.05,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4544.07,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14177.48,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4634.95,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6225.37,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14177.48,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18345.53,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":18525.38,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":18165.67,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":19244.82,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":17985.81,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":21582.97,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":11153.61,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":19244.82,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":18885.1,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":18345.53,"methodology":"case rate"}]}]},{"description":"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC","code_information":[{"code":"064","type":"MS-DRG"}],"standard_charges":[{"minimum":12161.6,"maximum":54896.08,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":26012.3,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":22372,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":29685,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":46848,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":26940,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25336.65,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":25336.65,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":23647.54,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":25336.65,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":16113,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":23671,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":23671,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":24982,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":22802.99,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":54896.08,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":36756,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":36756,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":12161.6,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25336.65,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":14418,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":26765,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":19876,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":29735,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":29735,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":25336.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":17228.93,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":16891.1,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":17397.84,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":16891.1,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":16891.1,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":17060.02,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":18073.48,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":16891.1,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":16891.1,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":16342.14,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":20269.32,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":18073.48,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":17735.66,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":17228.93,"methodology":"case rate"}]}]},{"description":"HC TCAT RMVL/DBLK ICAR MAS PERQ","code_information":[{"code":"0644T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":8847.9,"maximum":19662,"gross_charge":19662,"discounted_cash":6881.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":13763.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":12780.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":12780.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":13763.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":12780.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":13763.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":19662,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":14746.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":9831,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":16712.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10814.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":10814.1,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":8847.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":10814.1,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMVL/DBLK ICAR MAS PERQ","code_information":[{"code":"0644T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":19662,"gross_charge":19662,"discounted_cash":6881.7,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":11797.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":13763.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":12780.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":12780.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":13763.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":12780.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":13763.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":19662,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":14746.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8847.9,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":16712.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":9241.14,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10814.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":10814.1,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":7113.72,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16244.75,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":8061.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2162.82,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2898.18,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2162.82,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":10814.1,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6748,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2206.08,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2963.07,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6748,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":5308.74,"methodology":"fee schedule"}]}]},{"description":"HC TCAT IMPLTJ C SINS RDCTJ DEV","code_information":[{"code":"0645T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":18589.35,"maximum":41309.65,"gross_charge":41309.65,"discounted_cash":14458.38,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":41309.65,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":30982.24,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":20654.83,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":35113.21,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18589.35,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":22720.31,"methodology":"fee schedule"}]}]},{"description":"HC TCAT IMPLTJ C SINS RDCTJ DEV","code_information":[{"code":"0645T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":41309.65,"gross_charge":41309.65,"discounted_cash":14458.38,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":24785.79,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":26851.28,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":28916.76,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":41309.65,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":30982.24,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":18589.35,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":35113.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":19415.54,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":14945.84,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":34130.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":16936.96,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4544.07,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6089.05,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4544.07,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":22720.31,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14177.48,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4634.95,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6225.37,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14177.48,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":11153.61,"methodology":"fee schedule"}]}]},{"description":"HC TTVI/RPLCMT W/PRSTC VLV PERQ","code_information":[{"code":"0646T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":11533.05,"maximum":25629,"gross_charge":25629,"discounted_cash":8970.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":17940.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":16658.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":16658.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":17940.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":16658.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":17940.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":25629,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":19221.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":12814.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":21784.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":14095.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":14095.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":11533.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":14095.95,"methodology":"fee schedule"}]}]},{"description":"HC TTVI/RPLCMT W/PRSTC VLV PERQ","code_information":[{"code":"0646T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":25629,"gross_charge":25629,"discounted_cash":8970.15,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":15377.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":17940.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":16658.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":16658.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":17940.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":16658.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":17940.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":25629,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":19221.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":11533.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":21784.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":12045.63,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":14095.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":14095.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":9272.58,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21174.68,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":10507.89,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2819.19,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":3777.72,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2819.19,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":14095.95,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8795.88,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2875.58,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":3862.3,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8795.88,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":6919.83,"methodology":"fee schedule"}]}]},{"description":"HC QUAN MR ALYS TISS W/O MRI","code_information":[{"code":"0648T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1057.5,"maximum":2350,"gross_charge":2350,"discounted_cash":822.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1645,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1527.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1527.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1645,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1527.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1645,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2350,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1762.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1175,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1997.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1292.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1292.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1057.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1292.5,"methodology":"fee schedule"}]}]},{"description":"HC QUAN MR ALYS TISS W/O MRI","code_information":[{"code":"0648T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":2350,"gross_charge":2350,"discounted_cash":822.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1143,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":950,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1320,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1023,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1410,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1645,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1527.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1527.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1645,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1527.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1645,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1398.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2350,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1762.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1057.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1997.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2021,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1501,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1104.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1292.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1292.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":850.23,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1941.57,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":963.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1292.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":634.5,"methodology":"fee schedule"}]}]},{"description":"HC QUAN MR ALYS TISS W/MRI","code_information":[{"code":"0649T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2077.2,"maximum":4616,"gross_charge":4616,"discounted_cash":1615.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3231.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3000.4,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3000.4,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3231.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3000.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3231.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4616,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3462,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2308,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3923.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2538.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2538.8,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2077.2,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2538.8,"methodology":"fee schedule"}]}]},{"description":"HC QUAN MR ALYS TISS W/MRI","code_information":[{"code":"0649T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":4616,"gross_charge":4616,"discounted_cash":1615.6,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1143,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":950,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1320,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1023,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2769.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3231.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3000.4,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3000.4,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3231.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3000.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3231.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1398.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4616,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3462,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2077.2,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3923.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2021,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1501,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2169.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2538.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2538.8,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1670.07,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3813.74,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1892.56,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2538.8,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1246.32,"methodology":"fee schedule"}]}]},{"description":"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS","code_information":[{"code":"065","type":"MS-DRG"}],"standard_charges":[{"minimum":6725.96,"maximum":30360.24,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":14386.08,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11531,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":15175,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":23949,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":13772,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14012.42,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":14012.42,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":13078.26,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":14012.42,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":8237,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":12101,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":12101,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":12771,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":12611.18,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":30360.24,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":18790,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":18790,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6725.96,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14012.42,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7316,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":13682,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10161,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":15201,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":15201,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":14012.42,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9528.45,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9341.61,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":9621.86,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":9341.61,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":9341.61,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":9435.03,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":9995.53,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9341.61,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9341.61,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":9038.01,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":11209.94,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":9995.53,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":9808.7,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":9528.45,"methodology":"case rate"}]}]},{"description":"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC","code_information":[{"code":"066","type":"MS-DRG"}],"standard_charges":[{"minimum":4888.93,"maximum":22068.09,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":10456.88,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":7924,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":10272,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":16210,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":9322,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10185.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":10185.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":9506.26,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":10185.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":5575,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":8191,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":8191,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":8644,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":9166.75,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":22068.09,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":12718,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":12718,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":4888.93,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10185.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4949,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":9261,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":6877,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":10289,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":10289,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":10185.27,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":6925.99,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":6790.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":6993.89,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":6790.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":6790.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":6858.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":7265.5,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":6790.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":6790.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":6569.5,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":8148.22,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":7265.5,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":7129.69,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":6925.99,"methodology":"case rate"}]}]},{"description":"HC SCALP COOL 1ST MEAS&CALBRJ","code_information":[{"code":"0662T","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":2081.7,"maximum":4626,"gross_charge":4626,"discounted_cash":1619.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3238.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3006.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3006.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3238.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3006.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3238.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4626,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3469.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2313,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3932.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2544.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2544.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2081.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2544.3,"methodology":"fee schedule"}]}]},{"description":"HC SCALP COOL 1ST MEAS&CALBRJ","code_information":[{"code":"0662T","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":82,"maximum":4626,"gross_charge":4626,"discounted_cash":1619.1,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2775.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3238.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3006.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3006.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3238.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3006.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3238.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4626,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3469.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2081.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3932.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":110,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":123,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2174.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":123,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2544.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2544.3,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1673.69,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3822.01,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1896.66,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2544.3,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1249.02,"methodology":"fee schedule"}]}]},{"description":"HC SCALP COOL PLMT MNTR RMVL","code_information":[{"code":"0663T","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":91.35,"maximum":203,"gross_charge":203,"discounted_cash":71.05,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":142.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":131.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":131.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":142.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":131.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":142.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":203,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":152.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":101.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":172.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":111.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":111.65,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":91.35,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":111.65,"methodology":"fee schedule"}]}]},{"description":"HC SCALP COOL PLMT MNTR RMVL","code_information":[{"code":"0663T","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":54.81,"maximum":203,"gross_charge":203,"discounted_cash":71.05,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":121.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":142.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":131.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":131.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":142.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":131.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":142.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":203,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":152.25,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":91.35,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":172.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":110,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":123,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":95.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":123,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":111.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":111.65,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":73.45,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":167.72,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":83.23,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":111.65,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":54.81,"methodology":"fee schedule"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC","code_information":[{"code":"067","type":"MS-DRG"}],"standard_charges":[{"minimum":9174.6,"maximum":41413.1,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":19623.44,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":16043,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":21711,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":34264,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":19704,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19113.74,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":19113.74,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":17839.49,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":19113.74,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":11785,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":17313,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":17313,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":18272,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":17202.37,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":41413.1,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":26884,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":26884,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":9174.6,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19113.74,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":10199,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":19576,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":14537,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":21748,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":21748,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":19113.74,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12997.34,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12742.49,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":13124.77,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":12742.49,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":12742.49,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":12869.92,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":13634.47,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12742.49,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12742.49,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":12328.36,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":15290.99,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":13634.47,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":13379.62,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":12997.34,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC","code_information":[{"code":"068","type":"MS-DRG"}],"standard_charges":[{"minimum":5969.01,"maximum":26943.45,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":12767.05,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":10252,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":13155,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20760,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":11938,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12435.44,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12435.44,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":11606.41,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12435.44,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":7140,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":10490,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":10490,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":11071,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11191.9,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":26943.45,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":16288,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":16288,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5969.01,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12435.44,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6269,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":11861,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":8808,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":13177,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":13177,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12435.44,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8456.1,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8290.29,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8539,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8290.29,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8290.29,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8373.2,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8870.62,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8290.29,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8290.29,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8020.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9948.35,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8870.62,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8704.81,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8456.1,"methodology":"case rate"}]}]},{"description":"HC HISTOTRIPSY MAL HEPATOCELLULAR TISS W/IMG GDN","code_information":[{"code":"0686T","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":19719.9,"maximum":43822,"gross_charge":43822,"discounted_cash":15337.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":30675.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":28484.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":28484.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":30675.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":28484.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":30675.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":43822,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":32866.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":21911,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":37248.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":24102.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":24102.1,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":19719.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":24102.1,"methodology":"fee schedule"}]}]},{"description":"HC HISTOTRIPSY MAL HEPATOCELLULAR TISS W/IMG GDN","code_information":[{"code":"0686T","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":43822,"gross_charge":43822,"discounted_cash":15337.7,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":26293.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":30675.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":28484.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":28484.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":30675.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":28484.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":30675.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":43822,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":32866.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":19719.9,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":37248.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":20596.34,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":24102.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":24102.1,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":15854.8,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":36205.74,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":17967.02,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4820.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6459.37,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4820.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":24102.1,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15039.72,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4916.83,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6603.98,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15039.72,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":11831.94,"methodology":"fee schedule"}]}]},{"description":"TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC","code_information":[{"code":"069","type":"MS-DRG"}],"standard_charges":[{"minimum":5513.94,"maximum":24889.32,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":11793.71,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9052,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":11940,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":18843,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":10836,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11487.38,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":11487.38,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":10721.55,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":11487.38,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":6481,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":9521,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":9521,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":10048,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":10338.64,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":24889.32,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":14784,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":14784,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5513.94,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11487.38,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":5749,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":10765,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":7995,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":11960,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":11960,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":11487.38,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7811.42,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7658.25,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":7888,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":7658.25,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":7658.25,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":7734.84,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8194.33,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7658.25,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7658.25,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":7409.36,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9189.9,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8194.33,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8041.17,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":7811.42,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC","code_information":[{"code":"070","type":"MS-DRG"}],"standard_charges":[{"minimum":10761.74,"maximum":48577.27,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":23018.15,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":19561,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":25948,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":40950,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":23549,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22420.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":22420.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":20925.59,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":22420.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":14084,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":20692,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":20692,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":21838,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":20178.25,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":48577.27,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":32130,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":32130,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":10761.74,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22420.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":12881,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":23396,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":17374,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":25992,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":25992,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":22420.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15245.79,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":14946.85,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":15395.26,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":14946.85,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":14946.85,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":15096.32,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":15993.13,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":14946.85,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":14946.85,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":14461.08,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":17936.22,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":15993.13,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":15694.2,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":15245.79,"methodology":"case rate"}]}]},{"description":"HC ID CA IMMNTX PREP & 1ST NJX","code_information":[{"code":"0708T","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":25.65,"maximum":57,"gross_charge":57,"discounted_cash":19.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":39.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":37.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":37.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":39.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":37.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":39.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":57,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":42.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":28.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":48.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":25.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":31.35,"methodology":"fee schedule"}]}]},{"description":"HC ID CA IMMNTX PREP & 1ST NJX","code_information":[{"code":"0708T","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":15.39,"maximum":869,"gross_charge":57,"discounted_cash":19.95,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":34.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":57,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":57,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":57,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":39.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":37.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":37.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":39.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":37.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":39.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":57,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":42.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":25.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":48.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":782,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":582,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":869,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":26.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":869,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":20.63,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":47.1,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":23.37,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":15.39,"methodology":"fee schedule"}]}]},{"description":"NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC","code_information":[{"code":"071","type":"MS-DRG"}],"standard_charges":[{"minimum":6932.81,"maximum":31293.93,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":14828.51,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":12128,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":15727,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":24820,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":14273,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14443.35,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":14443.35,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":13480.46,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":14443.35,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":8537,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":12541,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":12541,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":13236,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":12999.02,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":31293.93,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":19474,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":19474,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6932.81,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14443.35,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7643,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":14180,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10531,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":15754,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":15754,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":14443.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9821.48,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9628.9,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":9917.77,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":9628.9,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":9628.9,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":9725.19,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":10302.93,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9628.9,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9628.9,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":9315.97,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":11554.68,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":10302.93,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":10110.35,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":9821.48,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC","code_information":[{"code":"072","type":"MS-DRG"}],"standard_charges":[{"minimum":5234.98,"maximum":23630.1,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":11197.04,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":8758,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":11195,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":17668,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":10160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10906.2,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":10906.2,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":10179.12,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":10906.2,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":6077,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":8927,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":8927,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":9422,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":9815.58,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":23630.1,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":13862,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":13862,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5234.98,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10906.2,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":5636,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":10094,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":7496,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":11214,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":11214,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":10906.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7416.22,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7270.8,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":7488.93,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":7270.8,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":7270.8,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":7343.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":7779.76,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7270.8,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7270.8,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":7034.5,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":8724.96,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":7779.76,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":7634.34,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":7416.22,"methodology":"case rate"}]}]},{"description":"HC QMRCP W/O DX MRI SM ANAT SES","code_information":[{"code":"0723T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":962.1,"maximum":2138,"gross_charge":2138,"discounted_cash":748.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1496.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1389.7,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1389.7,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1496.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1389.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1496.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2138,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1603.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1069,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1817.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1175.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1175.9,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":962.1,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1175.9,"methodology":"fee schedule"}]}]},{"description":"HC QMRCP W/O DX MRI SM ANAT SES","code_information":[{"code":"0723T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":2247,"gross_charge":2138,"discounted_cash":748.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1143,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":950,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1320,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1023,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1282.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1496.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1389.7,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1389.7,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1496.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1389.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1496.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1398.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2138,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1603.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":962.1,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1817.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2021,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1501,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1004.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1175.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1175.9,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":773.53,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1766.42,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":876.58,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1175.9,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":577.26,"methodology":"fee schedule"}]}]},{"description":"HC QMRCP W/DX MRI SAME ANATOMY","code_information":[{"code":"0724T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2029.95,"maximum":4511,"gross_charge":4511,"discounted_cash":1578.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3157.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2932.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2932.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3157.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2932.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3157.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4511,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3383.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2255.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3834.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2481.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2481.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2029.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2481.05,"methodology":"fee schedule"}]}]},{"description":"HC QMRCP W/DX MRI SAME ANATOMY","code_information":[{"code":"0724T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":4511,"gross_charge":4511,"discounted_cash":1578.85,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1143,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":950,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1320,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1023,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2706.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3157.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2932.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2932.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3157.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2932.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3157.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1398.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4511,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3383.25,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2029.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3834.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2021,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1501,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2120.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2481.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2481.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1632.08,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3726.99,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1849.51,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2481.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1217.97,"methodology":"fee schedule"}]}]},{"description":"CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC","code_information":[{"code":"073","type":"MS-DRG"}],"standard_charges":[{"minimum":9681.66,"maximum":43701.91,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":20707.98,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":17010,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":23065,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":36400,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":20932,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20170.11,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":20170.11,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":18825.44,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":20170.11,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":12519,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":18393,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":18393,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":19411,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":18153.1,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":43701.91,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":28560,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":28560,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":9681.66,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20170.11,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":10891,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":20796,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":15444,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":23104,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":23104,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":20170.11,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13715.68,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13446.74,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":13850.15,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":13446.74,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":13446.74,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":13581.21,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":14388.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13446.74,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13446.74,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":13009.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":16136.09,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":14388.02,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":14119.08,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":13715.68,"methodology":"case rate"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0731","type":"APR-DRG"}],"standard_charges":[{"minimum":5030,"maximum":18611,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5281.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5784.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":13882.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5030,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12072,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5030,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5130.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5130.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18611,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5130.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12323.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18611,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5180.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5180.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12424.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5180.9,"methodology":"case rate"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0732","type":"APR-DRG"}],"standard_charges":[{"minimum":6851,"maximum":25348.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7193.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7878.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":18908.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6851,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":16442.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6851,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6988.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6988.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":25348.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6988.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":16784.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":25348.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7056.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7056.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16921.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7056.53,"methodology":"case rate"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0733","type":"APR-DRG"}],"standard_charges":[{"minimum":9815,"maximum":36315.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":10305.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11287.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":27089.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9815,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":23556,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9815,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10011.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10011.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":36315.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10011.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":24046.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":36315.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10109.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":10109.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":24243.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10109.45,"methodology":"case rate"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0734","type":"APR-DRG"}],"standard_charges":[{"minimum":25145,"maximum":93036.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":26402.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":28916.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":69400.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25145,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":60348,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25145,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25647.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25647.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":93036.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25647.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":61605.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":93036.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25899.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":25899.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":62108.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25899.35,"methodology":"case rate"}]}]},{"description":"HC TX PLN MAG FLD ABLTJ PRST8","code_information":[{"code":"0738T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":580.05,"maximum":1289,"gross_charge":1289,"discounted_cash":451.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":902.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":837.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":837.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":902.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":837.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":902.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1289,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":966.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":644.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1095.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":708.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":708.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":580.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":708.95,"methodology":"fee schedule"}]}]},{"description":"HC TX PLN MAG FLD ABLTJ PRST8","code_information":[{"code":"0738T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":2247,"gross_charge":1289,"discounted_cash":451.15,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1143,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":950,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1320,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1023,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":773.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":902.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":837.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":837.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":902.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":837.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":902.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1398.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1289,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":966.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":580.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1095.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2021,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1501,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":605.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":708.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":708.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":466.37,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1064.98,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":528.49,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":708.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":348.03,"methodology":"fee schedule"}]}]},{"description":"HC ABLTJ MAL PRST8 MAG FLD NDCT","code_information":[{"code":"0739T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":831.15,"maximum":1847,"gross_charge":1847,"discounted_cash":646.45,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1292.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1200.55,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.55,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1292.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1200.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1292.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1847,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1385.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":923.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1569.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1015.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1015.85,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":831.15,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1015.85,"methodology":"fee schedule"}]}]},{"description":"HC ABLTJ MAL PRST8 MAG FLD NDCT","code_information":[{"code":"0739T","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":2247,"gross_charge":1847,"discounted_cash":646.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1143,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":950,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1320,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1023,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1108.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1292.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1200.55,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.55,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1292.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1200.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1292.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1398.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1847,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1385.25,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":831.15,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1569.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2021,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1501,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":868.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2247,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1015.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1015.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":668.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1526,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":757.27,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1015.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":498.69,"methodology":"fee schedule"}]}]},{"description":"CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC","code_information":[{"code":"074","type":"MS-DRG"}],"standard_charges":[{"minimum":6868.52,"maximum":31003.74,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":14691,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11613,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":15556,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":24550,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":14117,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14309.42,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":14309.42,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":13355.46,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":14309.42,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":8443,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":12405,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":12405,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":13092,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":12878.48,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":31003.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":19261,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":19261,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6868.52,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14309.42,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7387,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":14025,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10416,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":15582,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":15582,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":14309.42,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9730.41,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9539.61,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":9825.8,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":9539.61,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":9539.61,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":9635.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":10207.39,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9539.61,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9539.61,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":9229.58,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":11447.54,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":10207.39,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":10016.6,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":9730.41,"methodology":"case rate"}]}]},{"description":"HC AQMBF SPECT XERS/STRS & REST","code_information":[{"code":"0742T","type":"CPT"},{"code":"0340","type":"RC"}],"standard_charges":[{"minimum":1113.75,"maximum":2475,"gross_charge":2475,"discounted_cash":866.25,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1732.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1608.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1608.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1732.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1608.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1732.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2475,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1856.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1237.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2103.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1361.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1361.25,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1113.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1361.25,"methodology":"fee schedule"}]}]},{"description":"HC AQMBF SPECT XERS/STRS & REST","code_information":[{"code":"0742T","type":"CPT"},{"code":"0340","type":"RC"}],"standard_charges":[{"minimum":668.25,"maximum":3268,"gross_charge":2475,"discounted_cash":866.25,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1485,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":866.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1014.75,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":792,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1732.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1608.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1608.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1732.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1608.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1732.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2475,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1856.25,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1113.75,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2103.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2940,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":2184,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":3268,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1163.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":3268,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1361.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1361.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":895.46,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2044.85,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1014.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1361.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":668.25,"methodology":"fee schedule"}]}]},{"description":"HC B1 STR&FX RSK ASSMT DXR-BMD","code_information":[{"code":"0749T","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":417.6,"maximum":928,"gross_charge":928,"discounted_cash":324.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":928,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":696,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":464,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":788.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":417.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":510.4,"methodology":"fee schedule"}]}]},{"description":"HC B1 STR&FX RSK ASSMT DXR-BMD","code_information":[{"code":"0749T","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":928,"gross_charge":928,"discounted_cash":324.8,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":556.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":928,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":696,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":417.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":788.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":782,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":582,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":869,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":436.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":869,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":335.76,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":766.72,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":380.48,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":250.56,"methodology":"fee schedule"}]}]},{"description":"VIRAL MENINGITIS WITH CC/MCC","code_information":[{"code":"075","type":"MS-DRG"}],"standard_charges":[{"minimum":10670.05,"maximum":48163.41,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":22822.05,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":20705,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":25703,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":40564,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":23326,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22229.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":22229.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":20747.32,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":22229.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":13951,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":20497,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":20497,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":21632,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":20006.34,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":48163.41,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":31827,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":31827,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":10670.05,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22229.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":13775,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":23175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":17210,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":25746,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":25746,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":22229.27,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15115.91,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":14819.51,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":15264.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":14819.51,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":14819.51,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":14967.71,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":15856.88,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":14819.51,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":14819.51,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":14337.88,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":17783.42,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":15856.88,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":15560.49,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":15115.91,"methodology":"case rate"}]}]},{"description":"HC B1 STR&FX RSK ASMT DXRBMD1VW","code_information":[{"code":"0750T","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":223.65,"maximum":497,"gross_charge":497,"discounted_cash":173.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":347.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":323.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":323.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":347.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":323.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":347.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":497,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":372.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":248.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":422.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":273.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":273.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":223.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":273.35,"methodology":"fee schedule"}]}]},{"description":"HC B1 STR&FX RSK ASMT DXRBMD1VW","code_information":[{"code":"0750T","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":869,"gross_charge":497,"discounted_cash":173.95,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":298.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":347.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":323.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":323.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":347.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":323.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":347.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":497,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":372.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":223.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":422.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":782,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":582,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":869,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":233.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":869,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":273.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":273.35,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":179.82,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":410.63,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":203.77,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":273.35,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":134.19,"methodology":"fee schedule"}]}]},{"description":"VIRAL MENINGITIS WITHOUT CC/MCC","code_information":[{"code":"076","type":"MS-DRG"}],"standard_charges":[{"minimum":6166.92,"maximum":27836.77,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":13190.35,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11201,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":13683,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":12418,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12847.74,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12847.74,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":11991.23,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12847.74,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":7427,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":10911,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":10911,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":11515,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11562.97,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":27836.77,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":16942,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":16942,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6166.92,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12847.74,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6640,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":12337,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":9162,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":13706,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":13706,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12847.74,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8736.47,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8565.16,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8822.12,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8565.16,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8565.16,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8650.82,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":9164.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8565.16,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8565.16,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8286.8,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":10278.2,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":9164.73,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8993.42,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8736.47,"methodology":"case rate"}]}]},{"description":"HYPERTENSIVE ENCEPHALOPATHY WITH MCC","code_information":[{"code":"077","type":"MS-DRG"}],"standard_charges":[{"minimum":9685.57,"maximum":43719.56,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":20716.35,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":17746,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":23075,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":36417,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":20942,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20178.26,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":20178.26,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":18833.04,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":20178.26,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":12525,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":18401,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":18401,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":19420,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":18160.43,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":43719.56,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":28573,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":28573,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":9685.57,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20178.26,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":10875,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":20805,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":15451,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":23114,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":23114,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":20178.26,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13721.22,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13452.17,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":13855.74,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":13452.17,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":13452.17,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":13586.7,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":14393.83,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13452.17,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13452.17,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":13014.98,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":16142.61,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":14393.83,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":14124.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":13721.22,"methodology":"case rate"}]}]},{"description":"HYPERTENSIVE ENCEPHALOPATHY WITH CC","code_information":[{"code":"078","type":"MS-DRG"}],"standard_charges":[{"minimum":6619.74,"maximum":29880.76,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":14158.89,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11263,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":14892,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":23502,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":13515,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13791.12,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":13791.12,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":12871.72,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":13791.12,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":8083,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":11875,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":11875,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":12533,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":12412.01,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":29880.76,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":18439,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":18439,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6619.74,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13791.12,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7320,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":13427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":9971,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":14917,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":14917,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":13791.12,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9377.97,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9194.08,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":9469.91,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":9194.08,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":9194.08,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":9286.03,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":9837.67,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9194.08,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9194.08,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8895.28,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":11032.9,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":9837.67,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":9653.79,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":9377.97,"methodology":"case rate"}]}]},{"description":"HC INSTLJ FECAL MICROBIOTA SSP","code_information":[{"code":"0780T","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":1687.05,"maximum":3749,"gross_charge":3749,"discounted_cash":1312.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2624.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2436.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2436.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2624.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2436.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2624.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3749,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2811.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1874.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3186.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2061.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2061.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1687.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2061.95,"methodology":"fee schedule"}]}]},{"description":"HC INSTLJ FECAL MICROBIOTA SSP","code_information":[{"code":"0780T","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":82,"maximum":3749,"gross_charge":3749,"discounted_cash":1312.15,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2249.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2624.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2436.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2436.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2624.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2436.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2624.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3749,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2811.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1687.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3186.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":110,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":123,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1762.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":123,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2061.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2061.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1356.39,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3097.43,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1537.09,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2061.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1012.23,"methodology":"fee schedule"}]}]},{"description":"HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC","code_information":[{"code":"079","type":"MS-DRG"}],"standard_charges":[{"minimum":4768.18,"maximum":21523,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":10198.59,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":8326,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":9949,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":15701,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9933.69,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":9933.69,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":9271.45,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":9933.69,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":5400,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":7934,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":7934,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":8373,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":8940.33,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":21523,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":12319,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":12319,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":4768.18,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":9933.69,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":5332,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":8970,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":6662,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":9966,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":9966,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":9933.69,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":6754.91,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":6622.46,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":6821.14,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":6622.46,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":6622.46,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":6688.69,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":7086.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":6622.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":6622.46,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":6407.24,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":7946.96,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":7086.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":6953.59,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":6754.91,"methodology":"case rate"}]}]},{"description":"HC TCAT INS 2CHMBR LDLS PM CMPL","code_information":[{"code":"0795T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":20656.69,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":22951.88,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"}]}]},{"description":"HC TCAT INS 2CHMBR LDLS PM CMPL","code_information":[{"code":"0795T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":27542.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":21574.77,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":16607.98,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37925.68,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18820.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6766.22,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5150.41,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6917.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":12394.02,"methodology":"fee schedule"}]}]},{"description":"HC TCAT INS 2CHMBR LDLS PM RA","code_information":[{"code":"0796T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":20656.69,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":22951.88,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"}]}]},{"description":"HC TCAT INS 2CHMBR LDLS PM RA","code_information":[{"code":"0796T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":27542.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":21574.77,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":16607.98,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37925.68,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18820.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6766.22,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5150.41,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6917.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":12394.02,"methodology":"fee schedule"}]}]},{"description":"HC TCAT INS 2CHMBR LDLS PM RV","code_information":[{"code":"0797T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":20656.69,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":22951.88,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"}]}]},{"description":"HC TCAT INS 2CHMBR LDLS PM RV","code_information":[{"code":"0797T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":27542.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":21574.77,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":16607.98,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37925.68,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18820.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6766.22,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5150.41,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6917.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":12394.02,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV 2CHMBR LDLS PM CMPL","code_information":[{"code":"0798T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":3379.12,"maximum":7509.15,"gross_charge":7509.15,"discounted_cash":2628.21,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7509.15,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5631.87,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3754.58,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6382.78,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3379.12,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV 2CHMBR LDLS PM CMPL","code_information":[{"code":"0798T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":7509.15,"gross_charge":7509.15,"discounted_cash":2628.21,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":4505.49,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7509.15,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5631.87,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3379.12,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6382.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3529.31,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2716.82,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6204.06,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3078.76,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":826.01,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1106.85,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":826.01,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2577.15,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":842.53,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1131.63,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2577.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2027.48,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMVL 2CHMBR LDLS PM RA","code_information":[{"code":"0799T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":3379.12,"maximum":7509.15,"gross_charge":7509.15,"discounted_cash":2628.21,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7509.15,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5631.87,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3754.58,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6382.78,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3379.12,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMVL 2CHMBR LDLS PM RA","code_information":[{"code":"0799T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":7509.15,"gross_charge":7509.15,"discounted_cash":2628.21,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":4505.49,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7509.15,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5631.87,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3379.12,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6382.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3529.31,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2716.82,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6204.06,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3078.76,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":826.01,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1106.85,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":826.01,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2577.15,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":842.53,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1131.63,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2577.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2027.48,"methodology":"fee schedule"}]}]},{"description":"NONTRAUMATIC STUPOR AND COMA WITH MCC","code_information":[{"code":"080","type":"MS-DRG"}],"standard_charges":[{"minimum":12153.76,"maximum":54860.72,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":25995.54,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":23142,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":29664,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":46815,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":26921,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25320.33,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":25320.33,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":23632.31,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":25320.33,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":16101,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":23655,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":23655,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":24965,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":22788.3,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":54860.72,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":36731,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":36731,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":12153.76,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25320.33,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":15898,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":26746,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":19862,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":29714,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":29714,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":25320.33,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":17217.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":16880.22,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":17386.63,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":16880.22,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":16880.22,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":17049.03,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":18061.84,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":16880.22,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":16880.22,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":16331.62,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":20256.27,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":18061.84,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":17724.24,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":17217.83,"methodology":"case rate"}]}]},{"description":"HC TCAT RMVL 2CHMBR LDLS PM RV","code_information":[{"code":"0800T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":3379.12,"maximum":7509.15,"gross_charge":7509.15,"discounted_cash":2628.21,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7509.15,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5631.87,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3754.58,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6382.78,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3379.12,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMVL 2CHMBR LDLS PM RV","code_information":[{"code":"0800T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":7509.15,"gross_charge":7509.15,"discounted_cash":2628.21,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":4505.49,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7509.15,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5631.87,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3379.12,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6382.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3529.31,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2716.82,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6204.06,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3078.76,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":826.01,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1106.85,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":826.01,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2577.15,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":842.53,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1131.63,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2577.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2027.48,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV&RPL 2CHMBR LDLS PM","code_information":[{"code":"0801T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":20656.69,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":22951.88,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV&RPL 2CHMBR LDLS PM","code_information":[{"code":"0801T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":27542.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":21574.77,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":16607.98,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37925.68,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18820.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6766.22,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5150.41,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6917.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":12394.02,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV&RPL2CHMB LDLS PM RA","code_information":[{"code":"0802T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":20656.69,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":22951.88,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV&RPL2CHMB LDLS PM RA","code_information":[{"code":"0802T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":27542.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":21574.77,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":16607.98,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37925.68,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18820.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6766.22,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5150.41,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6917.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":12394.02,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV&RPL2CHMB LDLS PM RV","code_information":[{"code":"0803T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":20656.69,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":22951.88,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV&RPL2CHMB LDLS PM RV","code_information":[{"code":"0803T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":27542.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":21574.77,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":16607.98,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37925.68,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18820.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6766.22,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5150.41,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6917.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":12394.02,"methodology":"fee schedule"}]}]},{"description":"NONTRAUMATIC STUPOR AND COMA WITHOUT MCC","code_information":[{"code":"081","type":"MS-DRG"}],"standard_charges":[{"minimum":6099.27,"maximum":27531.4,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":13045.65,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":10193,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":13502,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":12254,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12706.8,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12706.8,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":11859.68,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12706.8,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":7329,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":10767,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":10767,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":11363,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11436.12,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":27531.4,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":16719,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":16719,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6099.27,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12706.8,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6547,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":12174,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":9041,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":13525,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":13525,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12706.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8640.63,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8471.2,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8725.34,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8471.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8471.2,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8555.92,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":9064.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8471.2,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8471.2,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8195.89,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":10165.44,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":9064.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8894.76,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8640.63,"methodology":"case rate"}]}]},{"description":"TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC","code_information":[{"code":"082","type":"MS-DRG"}],"standard_charges":[{"minimum":14012.05,"maximum":63248.81,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":29970.21,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":25700,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":34624,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":54643,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":31422,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29191.76,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":29191.76,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":27245.64,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":29191.76,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":18794,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":27610,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":27610,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":29139,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":26272.58,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":63248.81,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":42873,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":42873,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":14012.05,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29191.76,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":16399,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":31218,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":23183,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":34682,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":34682,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":29191.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":19850.4,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":19461.17,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":20045.01,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":19461.17,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":19461.17,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":19655.79,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":20823.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":19461.17,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":19461.17,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":18828.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":23353.41,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":20823.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":20434.23,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":19850.4,"methodology":"case rate"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0821","type":"APR-DRG"}],"standard_charges":[{"minimum":2239,"maximum":8284.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2350.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2574.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6179.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2239,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5373.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2239,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2283.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2283.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8284.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2283.78,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5485.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8284.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2306.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2306.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5530.33,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2306.17,"methodology":"case rate"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0822","type":"APR-DRG"}],"standard_charges":[{"minimum":4292,"maximum":15880.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4506.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4935.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11845.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4292,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10300.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4292,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4377.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4377.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15880.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4377.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10515.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15880.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4420.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4420.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10601.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4420.76,"methodology":"case rate"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0823","type":"APR-DRG"}],"standard_charges":[{"minimum":7669,"maximum":28375.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8052.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8819.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":21166.44,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7669,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":18405.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7669,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7822.38,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7822.38,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28375.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7822.38,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18789.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28375.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7899.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7899.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":18942.43,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7899.07,"methodology":"case rate"}]}]},{"description":"HC TCAT INS 1CHMBR LDLS PM RA","code_information":[{"code":"0823T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":20656.69,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":22951.88,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"}]}]},{"description":"HC TCAT INS 1CHMBR LDLS PM RA","code_information":[{"code":"0823T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":27542.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":21574.77,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":16607.98,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37925.68,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18820.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6766.22,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5150.41,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6917.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":12394.02,"methodology":"fee schedule"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0824","type":"APR-DRG"}],"standard_charges":[{"minimum":13327,"maximum":49309.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":13993.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15326.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":36782.52,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13327,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":31984.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13327,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":13593.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13593.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":49309.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13593.54,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":32651.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":49309.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13726.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":13726.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":32917.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13726.81,"methodology":"case rate"}]}]},{"description":"HC TCAT RMV 1CHMBR LDLS PM RA","code_information":[{"code":"0824T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":3379.12,"maximum":7509.15,"gross_charge":7509.15,"discounted_cash":2628.21,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7509.15,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5631.87,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3754.58,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6382.78,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3379.12,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV 1CHMBR LDLS PM RA","code_information":[{"code":"0824T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":7509.15,"gross_charge":7509.15,"discounted_cash":2628.21,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":4505.49,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4880.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5256.41,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7509.15,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5631.87,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3379.12,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6382.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3529.31,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2716.82,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6204.06,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3078.76,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":826.01,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1106.85,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":826.01,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4130.04,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2577.15,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":842.53,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1131.63,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2577.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2027.48,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV&RPL1CHMB LDLS PM RA","code_information":[{"code":"0825T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":20656.69,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":22951.88,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"}]}]},{"description":"HC TCAT RMV&RPL1CHMB LDLS PM RA","code_information":[{"code":"0825T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":45903.75,"gross_charge":45903.75,"discounted_cash":16066.32,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":27542.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":29837.44,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":32132.63,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":45903.75,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":34427.82,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":20656.69,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":39018.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":21574.77,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":16607.98,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37925.68,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":18820.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6766.22,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5049.42,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":25247.07,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5150.41,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6917.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15754.17,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":12394.02,"methodology":"fee schedule"}]}]},{"description":"TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC","code_information":[{"code":"083","type":"MS-DRG"}],"standard_charges":[{"minimum":8814.01,"maximum":39785.46,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":18852.19,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":15295,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":20749,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":32745,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":18830,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18362.52,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":18362.52,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":17138.36,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":18362.52,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":11262,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":16546,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":16546,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":17462,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":16526.27,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":39785.46,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":25692,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":25692,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8814.01,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18362.52,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":9763,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":18708,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":13893,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":20784,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":20784,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":18362.52,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12486.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12241.68,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":12608.94,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":12241.68,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":12241.68,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":12364.1,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":13098.6,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12241.68,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12241.68,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11843.83,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":14690.02,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":13098.6,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":12853.77,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":12486.52,"methodology":"case rate"}]}]},{"description":"TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC","code_information":[{"code":"084","type":"MS-DRG"}],"standard_charges":[{"minimum":6386.07,"maximum":28825.98,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":13659.08,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":10398,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":14268,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":22517,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":12948,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13304.3,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":13304.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":12417.35,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":13304.3,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":7744,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":11378,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":11378,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":12008,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11973.87,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":28825.98,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":17667,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":17667,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6386.07,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13304.3,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6620,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":12864,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":9553,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":14292,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":14292,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":13304.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9046.93,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8869.53,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":9135.62,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8869.53,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8869.53,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8958.23,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":9490.4,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8869.53,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8869.53,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8581.28,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":10643.44,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":9490.4,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":9313.01,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":9046.93,"methodology":"case rate"}]}]},{"description":"TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC","code_information":[{"code":"085","type":"MS-DRG"}],"standard_charges":[{"minimum":13709.04,"maximum":61881.08,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":29322.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":26499,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":33816,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":53367,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":30688,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28560.5,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":28560.5,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":26656.47,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":28560.5,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":18355,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":26965,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":26965,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":28459,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":25704.45,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":61881.08,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":41871,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":41871,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":13709.04,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":28560.5,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":16360,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":30489,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":22642,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":33872,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":33872,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":28560.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":19421.14,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":19040.33,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":19611.54,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":19040.33,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":19040.33,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":19230.74,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":20373.16,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":19040.33,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":19040.33,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":18421.52,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":22848.4,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":20373.16,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":19992.35,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":19421.14,"methodology":"case rate"}]}]},{"description":"TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC","code_information":[{"code":"086","type":"MS-DRG"}],"standard_charges":[{"minimum":8373.48,"maximum":37796.95,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":17909.94,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":14745,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":19573,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":30889,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":17763,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17444.75,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":17444.75,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":16281.77,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":17444.75,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":10624,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":15608,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":15608,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":16472,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":15700.28,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":37796.95,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":24236,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":24236,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8373.48,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17444.75,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":9480,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":17648,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":13106,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":19606,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":19606,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":17444.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11862.43,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11629.83,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":11978.73,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":11629.83,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":11629.83,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":11746.13,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":12443.92,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11629.83,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11629.83,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11251.87,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":13955.8,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":12443.92,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":12211.33,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":11862.43,"methodology":"case rate"}]}]},{"description":"HC RMVL PG WCS LV BOTH COMPNT","code_information":[{"code":"0861T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":4162.95,"maximum":9251,"gross_charge":9251,"discounted_cash":3237.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9251,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6938.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":4625.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7863.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4162.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"}]}]},{"description":"HC RMVL PG WCS LV BOTH COMPNT","code_information":[{"code":"0861T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":9251,"gross_charge":9251,"discounted_cash":3237.85,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":5550.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9251,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6938.25,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4162.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7863.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":4347.97,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3347.02,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7643.18,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3792.91,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1017.61,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1363.6,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1017.61,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3174.95,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1037.97,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1394.13,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3174.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2497.77,"methodology":"fee schedule"}]}]},{"description":"HC RLCJ PG WCS LV BATTERY ONLY","code_information":[{"code":"0862T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":2353.5,"maximum":5230,"gross_charge":5230,"discounted_cash":1830.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5230,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3922.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2615,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4445.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2353.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2876.5,"methodology":"fee schedule"}]}]},{"description":"HC RLCJ PG WCS LV BATTERY ONLY","code_information":[{"code":"0862T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":5230,"gross_charge":5230,"discounted_cash":1830.5,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3138,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5230,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3922.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2353.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4445.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2458.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1892.22,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4321.03,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2144.3,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":575.3,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":770.91,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":575.3,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1794.94,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":586.81,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":788.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1794.94,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1412.1,"methodology":"fee schedule"}]}]},{"description":"HC RLCJ PG WCS LV TRNSMTR ONLY","code_information":[{"code":"0863T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":2353.5,"maximum":5230,"gross_charge":5230,"discounted_cash":1830.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5230,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3922.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2615,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4445.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2353.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2876.5,"methodology":"fee schedule"}]}]},{"description":"HC RLCJ PG WCS LV TRNSMTR ONLY","code_information":[{"code":"0863T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":5230,"gross_charge":5230,"discounted_cash":1830.5,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3138,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3399.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3661,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5230,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3922.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2353.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4445.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2458.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1892.22,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4321.03,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2144.3,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":575.3,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":770.91,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":575.3,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2876.5,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1794.94,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":586.81,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":788.17,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1794.94,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1412.1,"methodology":"fee schedule"}]}]},{"description":"TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC","code_information":[{"code":"087","type":"MS-DRG"}],"standard_charges":[{"minimum":5982.99,"maximum":27006.53,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":12796.94,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9897,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":13192,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20819,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":11972,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12464.55,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12464.55,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":11633.58,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12464.55,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":7160,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":10520,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":10520,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":11102,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11218.1,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":27006.53,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":16335,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":16335,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5982.99,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12464.55,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6379,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":11894,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":8833,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":13214,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":13214,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12464.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8475.9,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8309.7,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8559,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8309.7,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8309.7,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8392.8,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8891.38,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8309.7,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8309.7,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8039.64,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9971.64,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8891.38,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8725.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8475.9,"methodology":"case rate"}]}]},{"description":"CONCUSSION WITH MCC","code_information":[{"code":"088","type":"MS-DRG"}],"standard_charges":[{"minimum":8927.5,"maximum":40297.73,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":19094.93,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":17883,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":21052,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":33223,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":19105,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18598.95,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":18598.95,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":17359.02,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":18598.95,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":11427,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":16787,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":16787,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":17717,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":16739.06,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":40297.73,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":26067,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":26067,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8927.5,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18598.95,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":11040,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":18981,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":14096,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":21087,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":21087,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":18598.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12647.29,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12399.3,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":12771.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":12399.3,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":12399.3,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":12523.3,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":13267.26,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12399.3,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12399.3,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11996.33,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":14879.16,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":13267.26,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":13019.27,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":12647.29,"methodology":"case rate"}]}]},{"description":"CONCUSSION WITH CC","code_information":[{"code":"089","type":"MS-DRG"}],"standard_charges":[{"minimum":7034.56,"maximum":31753.22,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":15046.14,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13248,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":15999,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25249,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":14519,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14655.33,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":14655.33,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":13678.31,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":14655.33,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":8684,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":12758,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":12758,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":13465,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":13189.8,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":31753.22,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":19810,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":19810,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":7034.56,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14655.33,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8277,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":14425,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10712,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":16026,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":16026,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":14655.33,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9965.63,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9770.22,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":10063.33,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":9770.22,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":9770.22,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":9867.93,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":10454.14,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9770.22,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9770.22,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":9452.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":11724.27,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":10454.14,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":10258.74,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":9965.63,"methodology":"case rate"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0891","type":"APR-DRG"}],"standard_charges":[{"minimum":10152,"maximum":37562.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":10659.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11674.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":28019.52,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10152,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":24364.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10152,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10355.04,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10355.04,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37562.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10355.04,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":24872.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":37562.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10456.56,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":10456.56,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":25075.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10456.56,"methodology":"case rate"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0892","type":"APR-DRG"}],"standard_charges":[{"minimum":10962,"maximum":40559.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11510.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12606.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":30255.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10962,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":26308.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10962,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11181.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11181.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":40559.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11181.24,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":26856.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":40559.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11290.86,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11290.86,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":27076.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11290.86,"methodology":"case rate"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0893","type":"APR-DRG"}],"standard_charges":[{"minimum":20022,"maximum":74081.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":21023.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23025.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":55260.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20022,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":48052.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":20022,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":20422.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":20422.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":74081.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20422.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":49053.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":74081.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20622.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":20622.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":49454.34,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":20622.66,"methodology":"case rate"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0894","type":"APR-DRG"}],"standard_charges":[{"minimum":37622,"maximum":139201.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":39503.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":43265.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":103836.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":37622,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":90292.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":37622,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":38374.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":38374.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":139201.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38374.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":92173.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":139201.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38750.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":38750.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":92926.34,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":38750.66,"methodology":"case rate"}]}]},{"description":"CONCUSSION WITHOUT CC/MCC","code_information":[{"code":"090","type":"MS-DRG"}],"standard_charges":[{"minimum":5833.73,"maximum":26332.77,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":12477.69,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9338,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":12793,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20190,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":11610,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12153.59,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12153.59,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":11343.35,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12153.59,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":6944,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":10202,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":10202,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":10767,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":10938.23,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":26332.77,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":15841,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":15841,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5833.73,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12153.59,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6729,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":11535,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":8566,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":12815,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":12815,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12153.59,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8264.44,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8102.39,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8345.47,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8102.39,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8102.39,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8183.42,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8669.56,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8102.39,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8102.39,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":7839.07,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9722.87,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8669.56,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8507.51,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8264.44,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC","code_information":[{"code":"091","type":"MS-DRG"}],"standard_charges":[{"minimum":11231.9,"maximum":50699.52,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":24023.77,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":19597,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":27203,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":42931,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":24688,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23399.78,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":23399.78,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":21839.79,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":23399.78,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":14765,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":21693,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":21693,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":22894,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":21059.8,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":50699.52,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":33684,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":33684,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":11231.9,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23399.78,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":12879,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":24527,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":18214,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":27249,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":27249,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":23399.78,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15911.85,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15599.85,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":16067.85,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":15599.85,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":15599.85,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":15755.85,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":16691.84,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":15599.85,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":15599.85,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":15092.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":18719.82,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":16691.84,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":16379.85,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":15911.85,"methodology":"case rate"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0911","type":"APR-DRG"}],"standard_charges":[{"minimum":5153,"maximum":19066.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5410.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5925.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":14222.28,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5153,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12367.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5153,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5256.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5256.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19066.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5256.06,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12624.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19066.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5307.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5307.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12727.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5307.59,"methodology":"case rate"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0912","type":"APR-DRG"}],"standard_charges":[{"minimum":11107,"maximum":41095.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11662.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12773.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":30655.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11107,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":26656.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11107,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11329.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11329.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":41095.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11329.14,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":27212.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":41095.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11440.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11440.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":27434.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11440.21,"methodology":"case rate"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0913","type":"APR-DRG"}],"standard_charges":[{"minimum":24536,"maximum":90783.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":25762.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":28216.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":67719.36,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24536,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":58886.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":24536,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":25026.72,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25026.72,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":90783.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25026.72,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":60113.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":90783.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25272.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":25272.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":60603.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25272.08,"methodology":"case rate"}]}]},{"description":"HC PRQ TCAT THER RX NTRAC BALO1","code_information":[{"code":"0913T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":13477.05,"maximum":29949,"gross_charge":29949,"discounted_cash":10482.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":20964.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":19466.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":19466.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":20964.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":19466.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":20964.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":29949,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":22461.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":14974.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":25456.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":16471.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":16471.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":13477.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":16471.95,"methodology":"fee schedule"}]}]},{"description":"HC PRQ TCAT THER RX NTRAC BALO1","code_information":[{"code":"0913T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":29949,"gross_charge":29949,"discounted_cash":10482.15,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":17969.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":20964.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":19466.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":19466.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":20964.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":19466.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":20964.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":29949,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":22461.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":13477.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":25456.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":14076.03,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":16471.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":16471.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":10835.55,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24743.87,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":12279.09,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3294.39,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":4414.49,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3294.39,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":16471.95,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10278.5,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3360.28,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":4513.32,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10278.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":8086.23,"methodology":"fee schedule"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0914","type":"APR-DRG"}],"standard_charges":[{"minimum":34196,"maximum":126525.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":35905.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":39325.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":94380.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":34196,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":82070.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":34196,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":34879.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":34879.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":126525.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":34879.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":83780.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":126525.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":35221.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":35221.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":84464.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":35221.88,"methodology":"case rate"}]}]},{"description":"HC PRQ TCAT THR RX NTRC BAL SEP","code_information":[{"code":"0914T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":3784.05,"maximum":8409,"gross_charge":8409,"discounted_cash":2943.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5886.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5465.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5465.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5886.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5465.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5886.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":8409,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6306.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":4204.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7147.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4624.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4624.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3784.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4624.95,"methodology":"fee schedule"}]}]},{"description":"HC PRQ TCAT THR RX NTRC BAL SEP","code_information":[{"code":"0914T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":8409,"gross_charge":8409,"discounted_cash":2943.15,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":5045.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5886.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5465.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5465.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5886.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5465.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5886.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":8409,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6306.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3784.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7147.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3952.23,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4624.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4624.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3042.38,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6947.52,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3447.69,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":924.99,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1239.49,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":924.99,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4624.95,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2885.97,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":943.49,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1267.24,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2885.97,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2270.43,"methodology":"fee schedule"}]}]},{"description":"HC INSJ PERM CCM-D SYS PG&ELTRD","code_information":[{"code":"0915T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":36000,"maximum":80000,"gross_charge":80000,"discounted_cash":28000,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":56000,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":52000,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":52000,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":56000,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":52000,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":56000,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":80000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":60000,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":40000,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":68000,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":44000,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":44000,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":36000,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":44000,"methodology":"fee schedule"}]}]},{"description":"HC INSJ PERM CCM-D SYS PG&ELTRD","code_information":[{"code":"0915T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":80000,"gross_charge":80000,"discounted_cash":28000,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":48000,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":56000,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":52000,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":52000,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":56000,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":52000,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":56000,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":80000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":60000,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":36000,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":68000,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":37600,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":44000,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":44000,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":28944,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":66096,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":32800,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8800,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11792,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8800,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":44000,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27456,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8976,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12056,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27456,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":21600,"methodology":"fee schedule"}]}]},{"description":"HC INSJ PERM CCM-D SYS PG ONLY","code_information":[{"code":"0916T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":26100,"maximum":58000,"gross_charge":58000,"discounted_cash":20300,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":40600,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":37700,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":37700,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":40600,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":37700,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":40600,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":58000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":43500,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":29000,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":49300,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":31900,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":31900,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":26100,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":31900,"methodology":"fee schedule"}]}]},{"description":"HC INSJ PERM CCM-D SYS PG ONLY","code_information":[{"code":"0916T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":58000,"gross_charge":58000,"discounted_cash":20300,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":34800,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":40600,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":37700,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":37700,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":40600,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":37700,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":40600,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":58000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":43500,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":26100,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":49300,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":27260,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":31900,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":31900,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":20984.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":47919.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":23780,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6380,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8549.2,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6380,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":31900,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19905.6,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6507.6,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8740.6,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19905.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":15660,"methodology":"fee schedule"}]}]},{"description":"HC INSJ PERM CCM-D SYS 1 LEAD","code_information":[{"code":"0917T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":9310.5,"maximum":20690,"gross_charge":20690,"discounted_cash":7241.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":14483,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":13448.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13448.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":14483,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":13448.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":14483,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":20690,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":15517.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":10345,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":17586.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11379.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":11379.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":9310.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":11379.5,"methodology":"fee schedule"}]}]},{"description":"HC INSJ PERM CCM-D SYS 1 LEAD","code_information":[{"code":"0917T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":20690,"gross_charge":20690,"discounted_cash":7241.5,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":12414,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":14483,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":13448.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13448.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":14483,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":13448.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":14483,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":20690,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":15517.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":9310.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":17586.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":9724.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11379.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":11379.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":7485.65,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17094.08,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":8482.9,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2275.9,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":3049.71,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2275.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":11379.5,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7100.81,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2321.42,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":3117.99,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7100.81,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":5586.3,"methodology":"fee schedule"}]}]},{"description":"HC INSJ PERM CCM-D SYS DUAL LD","code_information":[{"code":"0918T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":9000,"maximum":20000,"gross_charge":20000,"discounted_cash":7000,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":14000,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":13000,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13000,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":14000,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":13000,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":14000,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":20000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":15000,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":10000,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":17000,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11000,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":11000,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":9000,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":11000,"methodology":"fee schedule"}]}]},{"description":"HC INSJ PERM CCM-D SYS DUAL LD","code_information":[{"code":"0918T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":20000,"gross_charge":20000,"discounted_cash":7000,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":12000,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":14000,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":13000,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13000,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":14000,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":13000,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":14000,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":20000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":15000,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":9000,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":17000,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":9400,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11000,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":11000,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":7236,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16524,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":8200,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2200,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2948,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2200,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":11000,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6864,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2244,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":3014,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6864,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":5400,"methodology":"fee schedule"}]}]},{"description":"HC RMVL PERM CCM-D SYS PG ONLY","code_information":[{"code":"0919T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":4094.1,"maximum":9098,"gross_charge":9098,"discounted_cash":3184.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6368.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5913.7,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5913.7,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6368.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5913.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6368.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9098,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6823.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":4549,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7733.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5003.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5003.9,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4094.1,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5003.9,"methodology":"fee schedule"}]}]},{"description":"HC RMVL PERM CCM-D SYS PG ONLY","code_information":[{"code":"0919T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":9098,"gross_charge":9098,"discounted_cash":3184.3,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":5458.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6368.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5913.7,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5913.7,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6368.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5913.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6368.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9098,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6823.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4094.1,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7733.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":4276.06,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5003.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5003.9,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3291.66,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7516.77,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3730.18,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1000.78,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1341.05,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1000.78,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5003.9,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3122.44,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1020.8,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1371.07,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3122.44,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2456.46,"methodology":"fee schedule"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM WITH CC","code_information":[{"code":"092","type":"MS-DRG"}],"standard_charges":[{"minimum":6959.65,"maximum":31415.06,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":14885.91,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11280,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":15799,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":24933,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":14338,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14499.26,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":14499.26,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":13532.64,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":14499.26,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":8575,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":12599,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":12599,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":13296,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":13049.33,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":31415.06,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":19563,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":19563,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6959.65,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14499.26,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7386,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":14245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10579,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":15825,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":15825,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":14499.26,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9859.5,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9666.17,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":9956.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":9666.17,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":9666.17,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":9762.84,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":10342.81,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9666.17,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9666.17,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":9352.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":11599.41,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":10342.81,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":10149.48,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":9859.5,"methodology":"case rate"}]}]},{"description":"HC RMVL PERM CCM-D SYS 1 PAC LD","code_information":[{"code":"0920T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":4162.95,"maximum":9251,"gross_charge":9251,"discounted_cash":3237.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9251,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6938.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":4625.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7863.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4162.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"}]}]},{"description":"HC RMVL PERM CCM-D SYS 1 PAC LD","code_information":[{"code":"0920T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":9251,"gross_charge":9251,"discounted_cash":3237.85,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":5550.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9251,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6938.25,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4162.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7863.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":4347.97,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3347.02,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7643.18,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3792.91,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1017.61,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1363.6,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1017.61,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3174.95,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1037.97,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1394.13,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3174.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2497.77,"methodology":"fee schedule"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0921","type":"APR-DRG"}],"standard_charges":[{"minimum":7723,"maximum":28575.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8109.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8881.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":21315.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7723,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":18535.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7723,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7877.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7877.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28575.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7877.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18921.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28575.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7954.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7954.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":19075.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7954.69,"methodology":"case rate"}]}]},{"description":"HC RMVL PERM CCM-D SYS 1 DFB LD","code_information":[{"code":"0921T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":4162.95,"maximum":9251,"gross_charge":9251,"discounted_cash":3237.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9251,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6938.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":4625.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7863.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4162.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"}]}]},{"description":"HC RMVL PERM CCM-D SYS 1 DFB LD","code_information":[{"code":"0921T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":9251,"gross_charge":9251,"discounted_cash":3237.85,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":5550.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6013.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6475.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9251,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6938.25,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4162.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7863.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":4347.97,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3347.02,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7643.18,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3792.91,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1017.61,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1363.6,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1017.61,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5088.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3174.95,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1037.97,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1394.13,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3174.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2497.77,"methodology":"fee schedule"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0922","type":"APR-DRG"}],"standard_charges":[{"minimum":9067,"maximum":33547.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9520.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10427.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":25024.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9067,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":21760.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9067,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9248.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9248.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33547.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9248.34,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":22214.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33547.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9339.01,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9339.01,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":22395.49,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9339.01,"methodology":"case rate"}]}]},{"description":"HC RMVL PERM CCM-D SYS DUAL LD","code_information":[{"code":"0922T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":4275,"maximum":9500,"gross_charge":9500,"discounted_cash":3325,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6650,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6175,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6175,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6650,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6175,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6650,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9500,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":7125,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":4750,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":8075,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5225,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5225,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4275,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5225,"methodology":"fee schedule"}]}]},{"description":"HC RMVL PERM CCM-D SYS DUAL LD","code_information":[{"code":"0922T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":9500,"gross_charge":9500,"discounted_cash":3325,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":5700,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6650,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":6175,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":6175,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6650,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":6175,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6650,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9500,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":7125,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4275,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":8075,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":4465,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5225,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":5225,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3437.1,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7848.9,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3895,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1045,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1400.3,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1045,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":5225,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3260.4,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1065.9,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1431.65,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3260.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2565,"methodology":"fee schedule"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0923","type":"APR-DRG"}],"standard_charges":[{"minimum":27946,"maximum":103400.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":29343.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":32137.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":77130.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":27946,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":67070.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":27946,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":28504.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":28504.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":103400.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":28504.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":68467.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":103400.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":28784.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":28784.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":69026.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":28784.38,"methodology":"case rate"}]}]},{"description":"HC RMVL&RPLCMT PERM CCM-D PG","code_information":[{"code":"0923T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":25251.75,"maximum":56115,"gross_charge":56115,"discounted_cash":19640.25,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":39280.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":36474.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":36474.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":39280.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":36474.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":39280.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":56115,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":42086.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":28057.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":47697.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":30863.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":30863.25,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":25251.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":30863.25,"methodology":"fee schedule"}]}]},{"description":"HC RMVL&RPLCMT PERM CCM-D PG","code_information":[{"code":"0923T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":56115,"gross_charge":56115,"discounted_cash":19640.25,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":33669,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":39280.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":36474.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":36474.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":39280.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":36474.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":39280.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":56115,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":42086.25,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":25251.75,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":47697.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":26374.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":30863.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":30863.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":20302.41,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":46362.22,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":23007.15,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6172.65,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8271.36,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6172.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":30863.25,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19258.67,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6296.11,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8456.54,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19258.67,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":15151.05,"methodology":"fee schedule"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0924","type":"APR-DRG"}],"standard_charges":[{"minimum":28973,"maximum":107200.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":30421.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":33318.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":79965.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":28973,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":69535.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":28973,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":29552.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":29552.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":107200.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":29552.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":70983.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":107200.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":29842.19,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":29842.19,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":71563.31,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":29842.19,"methodology":"case rate"}]}]},{"description":"HC RPOS PRV CCM-D TRNSVNS ELTRD","code_information":[{"code":"0924T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":2700,"maximum":6000,"gross_charge":6000,"discounted_cash":2100,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4200,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3900,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3900,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4200,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3900,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4200,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":6000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4500,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3000,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":5100,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3300,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3300,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2700,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3300,"methodology":"fee schedule"}]}]},{"description":"HC RPOS PRV CCM-D TRNSVNS ELTRD","code_information":[{"code":"0924T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":6000,"gross_charge":6000,"discounted_cash":2100,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3600,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4200,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3900,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3900,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4200,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3900,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4200,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":6000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4500,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2700,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":5100,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2820,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3300,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3300,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2170.8,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4957.2,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2460,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":660,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":884.4,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":660,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3300,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2059.2,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":673.2,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":904.2,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2059.2,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1620,"methodology":"fee schedule"}]}]},{"description":"HC RLCJ SKIN POCKET CCM-D PG","code_information":[{"code":"0925T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":2057.85,"maximum":4573,"gross_charge":4573,"discounted_cash":1600.55,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3201.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2972.45,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2972.45,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3201.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2972.45,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3201.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4573,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3429.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2286.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3887.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2515.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2515.15,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2057.85,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2515.15,"methodology":"fee schedule"}]}]},{"description":"HC RLCJ SKIN POCKET CCM-D PG","code_information":[{"code":"0925T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":4573,"gross_charge":4573,"discounted_cash":1600.55,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2743.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3201.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2972.45,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2972.45,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3201.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2972.45,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3201.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4573,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3429.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2057.85,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3887.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2149.31,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2515.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2515.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1654.52,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3778.22,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1874.93,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":503.03,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":674.07,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":503.03,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2515.15,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1569.46,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":513.1,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":689.16,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1569.46,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1234.71,"methodology":"fee schedule"}]}]},{"description":"HC PRGRMG DEV EVAL CCM-D IP","code_information":[{"code":"0926T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":900,"maximum":2000,"gross_charge":2000,"discounted_cash":700,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1400,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1300,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1300,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1400,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1300,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1400,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1500,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1000,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1700,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":900,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1100,"methodology":"fee schedule"}]}]},{"description":"HC PRGRMG DEV EVAL CCM-D IP","code_information":[{"code":"0926T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":2000,"gross_charge":2000,"discounted_cash":700,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1200,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1400,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1300,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1300,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1400,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1300,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1400,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1500,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":900,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1700,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":940,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":723.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1652.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":820,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":220,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":294.8,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":220,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":686.4,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":224.4,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":301.4,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":686.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":540,"methodology":"fee schedule"}]}]},{"description":"HC INTERROG DEV EVAL CCM-D IP","code_information":[{"code":"0927T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":450,"maximum":1000,"gross_charge":1000,"discounted_cash":350,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":700,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":650,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":650,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":700,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":650,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":700,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":750,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":500,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":850,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":550,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":550,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":450,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":550,"methodology":"fee schedule"}]}]},{"description":"HC INTERROG DEV EVAL CCM-D IP","code_information":[{"code":"0927T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":1000,"gross_charge":1000,"discounted_cash":350,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":600,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":700,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":650,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":650,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":700,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":650,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":700,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1000,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":750,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":450,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":850,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":470,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":550,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":550,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":361.8,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":826.2,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":410,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":110,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":147.4,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":110,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":550,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":343.2,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":112.2,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":150.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":343.2,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":270,"methodology":"fee schedule"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC","code_information":[{"code":"093","type":"MS-DRG"}],"standard_charges":[{"minimum":5453.57,"maximum":24616.8,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":11664.58,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":8677,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":11779,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":18589,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":10689,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11361.6,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":11361.6,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":10604.16,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":11361.6,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":6393,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":9393,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":9393,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":9913,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":10225.44,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":24616.8,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":14585,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":14585,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5453.57,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11361.6,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":5574,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":10620,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":7887,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":11798,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":11798,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":11361.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7725.89,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7574.4,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":7801.64,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":7574.4,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":7574.4,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":7650.15,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8104.61,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7574.4,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7574.4,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":7328.24,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9089.28,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8104.61,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":7953.12,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":7725.89,"methodology":"case rate"}]}]},{"description":"HC TCAT IMPL WRLS L ATR PRS SNR","code_information":[{"code":"0933T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":6453.45,"maximum":14341,"gross_charge":14341,"discounted_cash":5019.35,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":10038.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":9321.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9321.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":10038.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":9321.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":10038.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":14341,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":10755.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":7170.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":12189.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7887.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":7887.55,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":6453.45,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":7887.55,"methodology":"fee schedule"}]}]},{"description":"HC TCAT IMPL WRLS L ATR PRS SNR","code_information":[{"code":"0933T","type":"CPT"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":14341,"gross_charge":14341,"discounted_cash":5019.35,"setting":"outpatient","payers_information":[{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":8604.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":10038.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":9321.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9321.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":10038.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":9321.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":10038.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":14341,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":10755.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6453.45,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":12189.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":6740.27,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7887.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":7887.55,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":5188.58,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11848.54,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":5879.81,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1577.51,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2113.87,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1577.51,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":7887.55,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4921.84,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1609.07,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2161.19,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4921.84,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":3872.07,"methodology":"fee schedule"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC","code_information":[{"code":"094","type":"MS-DRG"}],"standard_charges":[{"minimum":21439.01,"maximum":96773.27,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":45855.65,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":40541,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":54450,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":85931,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":49414,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44664.59,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":44664.59,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":41686.95,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":44664.59,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":29554,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":43420,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":43420,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":45824,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":40198.13,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":96773.27,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":67421,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":67421,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":21439.01,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":44664.59,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":26076,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":49093,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":36458,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":54541,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":54541,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":44664.59,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":30371.92,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":29776.39,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":30669.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":29776.39,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":29776.39,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":30074.16,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":31860.74,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":29776.39,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":29776.39,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":28808.66,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":35731.67,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":31860.74,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":31265.21,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":30371.92,"methodology":"case rate"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC","code_information":[{"code":"095","type":"MS-DRG"}],"standard_charges":[{"minimum":14442.51,"maximum":65191.88,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":30890.93,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":29007,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":35773,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":56456,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":32465,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":28082.66,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":19417,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":28527,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":28527,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":30106,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":27079.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":65191.88,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":44295,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":44295,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":14442.51,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":17161,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":32254,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":23953,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":35833,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":35833,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":20460.23,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":20660.82,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":20259.64,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":21463.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":19407.13,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":24070.85,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":21463.18,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":21062,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":20460.23,"methodology":"case rate"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0951","type":"APR-DRG"}],"standard_charges":[{"minimum":4399,"maximum":16276.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4618.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5058.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":12141.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4399,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10557.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4399,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4486.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4486.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16276.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4486.98,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10777.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16276.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4530.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4530.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10865.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4530.97,"methodology":"case rate"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0952","type":"APR-DRG"}],"standard_charges":[{"minimum":6412,"maximum":23724.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6732.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7373.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":17697.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6412,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":15388.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6412,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6540.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6540.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23724.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6540.24,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":15709.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23724.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6604.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6604.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":15837.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6604.36,"methodology":"case rate"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0953","type":"APR-DRG"}],"standard_charges":[{"minimum":9058,"maximum":33514.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9510.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10416.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":25000.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9058,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":21739.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9058,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9239.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9239.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33514.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9239.16,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":22192.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33514.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9329.74,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9329.74,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":22373.26,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9329.74,"methodology":"case rate"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0954","type":"APR-DRG"}],"standard_charges":[{"minimum":17955,"maximum":66433.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":18852.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20648.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":49555.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":17955,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":43092,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":17955,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":18314.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18314.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":66433.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18314.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":43989.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":66433.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":18493.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":18493.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":44348.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":18493.65,"methodology":"case rate"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC","code_information":[{"code":"096","type":"MS-DRG"}],"standard_charges":[{"minimum":14442.51,"maximum":65191.88,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":30890.93,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":25915,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":35773,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":56456,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":32465,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":28082.66,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":19417,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":28527,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":28527,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":30106,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":27079.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":65191.88,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":44295,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":44295,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":14442.51,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":15689,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":32254,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":23953,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":35833,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":35833,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":30088.56,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":20460.23,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":20660.82,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":20259.64,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":21463.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20059.04,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":19407.13,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":24070.85,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":21463.18,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":21062,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":20460.23,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC","code_information":[{"code":"097","type":"MS-DRG"}],"standard_charges":[{"minimum":21080.65,"maximum":95155.71,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":45089.17,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":44112,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":53493,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":84421,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":48546,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43918.02,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":43918.02,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":40990.16,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":43918.02,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":29035,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":42657,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":42657,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":45019,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":39526.22,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":95155.71,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":66236,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":66236,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":21080.65,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":43918.02,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":26178,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":48231,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":35817,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":53583,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":53583,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":43918.02,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":29864.26,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":29278.68,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":30157.05,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":29278.68,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":29278.68,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":29571.47,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":31328.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":29278.68,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":29278.68,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":28327.13,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":35134.42,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":31328.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":30742.62,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":29864.26,"methodology":"case rate"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0971","type":"APR-DRG"}],"standard_charges":[{"minimum":3420,"maximum":12654,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3591,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3933,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":9439.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3420,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8208,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3420,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3488.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3488.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12654,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3488.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8379,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12654,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3522.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3522.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8447.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3522.6,"methodology":"case rate"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0972","type":"APR-DRG"}],"standard_charges":[{"minimum":4825,"maximum":17852.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5066.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5548.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":13317,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4825,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11580,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4825,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4921.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4921.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17852.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4921.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":11821.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17852.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4969.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4969.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":11917.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4969.75,"methodology":"case rate"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0973","type":"APR-DRG"}],"standard_charges":[{"minimum":6450,"maximum":23865,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6772.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7417.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":17802,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6450,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":15480,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6450,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6579,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6579,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23865,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6579,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":15802.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23865,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6643.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6643.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":15931.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6643.5,"methodology":"case rate"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0974","type":"APR-DRG"}],"standard_charges":[{"minimum":14887,"maximum":55081.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":15631.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":17120.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":41088.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14887,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":35728.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14887,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":15184.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15184.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":55081.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15184.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":36473.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":55081.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15333.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":15333.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":36770.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15333.61,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC","code_information":[{"code":"098","type":"MS-DRG"}],"standard_charges":[{"minimum":13168.44,"maximum":59440.85,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":28165.82,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":23645,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":32372,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":51089,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":29379,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27434.24,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":27434.24,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":25605.29,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":27434.24,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":17571,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":25815,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":25815,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":27244,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":24690.82,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":59440.85,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":40084,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":40084,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":13168.44,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27434.24,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":15508,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":29188,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":21676,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":32427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":32427,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":27434.24,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18655.28,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18289.49,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":18838.18,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":18289.49,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":18289.49,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":18472.39,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":19569.76,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18289.49,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18289.49,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":17695.09,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":21947.39,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":19569.76,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":19203.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":18655.28,"methodology":"case rate"}]}]},{"description":"OTHER EAR NOSE MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0981","type":"APR-DRG"}],"standard_charges":[{"minimum":5390,"maximum":19943,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5659.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6198.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":14876.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5390,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12936,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5390,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5497.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5497.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19943,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5497.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":13205.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19943,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5551.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5551.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":13313.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5551.7,"methodology":"case rate"}]}]},{"description":"OTHER EAR NOSE MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0982","type":"APR-DRG"}],"standard_charges":[{"minimum":7607,"maximum":28145.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7987.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8748.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":20995.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7607,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":18256.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7607,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7759.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7759.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28145.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7759.14,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18637.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28145.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7835.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7835.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":18789.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7835.21,"methodology":"case rate"}]}]},{"description":"OTHER EAR NOSE MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0983","type":"APR-DRG"}],"standard_charges":[{"minimum":13150,"maximum":48655,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":13807.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15122.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":36294,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13150,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":31560,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13150,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":13413,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13413,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":48655,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13413,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":32217.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":48655,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13544.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":13544.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":32480.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13544.5,"methodology":"case rate"}]}]},{"description":"OTHER EAR NOSE MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0984","type":"APR-DRG"}],"standard_charges":[{"minimum":24448,"maximum":90457.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":25670.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":28115.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":67476.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24448,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":58675.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":24448,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":24936.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":24936.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":90457.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":24936.96,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":59897.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":90457.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25181.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":25181.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":60386.56,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25181.44,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC","code_information":[{"code":"099","type":"MS-DRG"}],"standard_charges":[{"minimum":8830.22,"maximum":39858.62,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":18886.86,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":15866,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":20792,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":32814,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":18869,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18396.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":18396.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":17169.87,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":18396.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":11286,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":16580,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":16580,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":17498,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":16556.66,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":39858.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":25745,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":25745,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8830.22,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18396.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":9503,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":18747,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":13922,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":20827,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":20827,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":18396.29,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12509.48,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12264.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":12632.12,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":12264.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":12264.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":12386.84,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":13122.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12264.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12264.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11865.61,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":14717.03,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":13122.69,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":12877.4,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":12509.48,"methodology":"case rate"}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0B6M0Z1","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0BYK0Z0","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0BYK0Z1","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0BYK0Z2","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0BYL0Z0","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0BYL0Z1","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0BYL0Z2","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0BYM0Z0","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0BYM0Z1","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CIGNA TRANSPLANT - LUNG AND HEART/LUNG","code_information":[{"code":"0BYM0Z2","type":"ICD"}],"standard_charges":[{"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"SEIZURES WITH MCC","code_information":[{"code":"100","type":"MS-DRG"}],"standard_charges":[{"minimum":12139.79,"maximum":54797.64,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":25965.65,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":21794,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":29627,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":46756,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":26887,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25291.22,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":25291.22,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":23605.14,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":25291.22,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":16081,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":23625,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":23625,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":24933,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":22762.1,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":54797.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":36684,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":36684,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":12139.79,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25291.22,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":14270,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":26712,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":19837,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":29676,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":29676,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":25291.22,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":17198.03,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":16860.81,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":17366.64,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":16860.81,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":16860.81,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":17029.42,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":18041.07,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":16860.81,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":16860.81,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":16312.84,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":20232.98,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":18041.07,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":17703.86,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":17198.03,"methodology":"case rate"}]}]},{"description":"FNA BX W/O IMG GDN EA ADDL","code_information":[{"code":"10004","type":"CPT"}],"standard_charges":[{"minimum":896,"maximum":2172,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"HC ASPIRATION FINE NEEDLE 10005","code_information":[{"code":"10005","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":2353.05,"maximum":5229,"gross_charge":5229,"discounted_cash":1830.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3660.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3398.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3398.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3660.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3398.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3660.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5229,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3921.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2614.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4444.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2875.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2875.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2353.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2875.95,"methodology":"fee schedule"}]}]},{"description":"HC ASPIRATION FINE NEEDLE 10005","code_information":[{"code":"10005","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":69.06,"maximum":5229,"gross_charge":5229,"discounted_cash":1830.15,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3660.3,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":81.08,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":161.4,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":69.06,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":171.91,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":125.37,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3137.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3660.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3398.85,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3398.85,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3660.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3398.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3660.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5229,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3921.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2353.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4444.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2457.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":311.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2875.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2875.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":417.34,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1891.86,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4320.2,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2143.89,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2875.95,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":371.27,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1411.83,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC FNA W/US EA ADD LESION","code_information":[{"code":"10006","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":1435.5,"maximum":3190,"gross_charge":3190,"discounted_cash":1116.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2233,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2073.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2073.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2233,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2073.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2233,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3190,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2392.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1595,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2711.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1754.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1754.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1435.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1754.5,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/US EA ADD LESION","code_information":[{"code":"10006","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":3190,"gross_charge":3190,"discounted_cash":1116.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2233,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1914,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2233,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2073.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2073.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2233,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2073.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2233,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3190,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2392.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1435.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2711.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1499.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1754.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1754.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1154.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2635.58,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1307.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1754.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":861.3,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/FLUORO 1ST LESION","code_information":[{"code":"10007","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":1270.8,"maximum":2824,"gross_charge":2824,"discounted_cash":988.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1976.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1835.6,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1835.6,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1976.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1835.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1976.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2824,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2118,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1412,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2400.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1553.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1553.2,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1270.8,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1553.2,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/FLUORO 1ST LESION","code_information":[{"code":"10007","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":204.16,"maximum":5160,"gross_charge":2824,"discounted_cash":988.4,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1976.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":251.01,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":499.7,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":213.83,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":532.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":388.14,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1694.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1976.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1835.6,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1835.6,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1976.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1835.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1976.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2824,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2118,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1270.8,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2400.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1327.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.37,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":234.78,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1553.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1553.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":314.41,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.73,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2333.19,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1157.84,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":204.16,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":273.57,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":204.16,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1553.2,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":208.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":208.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":636.98,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":208.24,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":279.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":636.98,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":204.16,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":204.16,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":273.57,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":204.16,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":762.48,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC W/FLUORO EA ADD LESION","code_information":[{"code":"10008","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":635.4,"maximum":1412,"gross_charge":1412,"discounted_cash":494.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1412,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1059,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":706,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":635.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"}]}]},{"description":"HC W/FLUORO EA ADD LESION","code_information":[{"code":"10008","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":2172,"gross_charge":1412,"discounted_cash":494.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":847.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1412,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1059,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":635.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":663.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":510.87,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1166.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":578.92,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":381.24,"methodology":"fee schedule"}]}]},{"description":"HC FINE NEEDLE ASPIRAT DEEP TISS","code_information":[{"code":"10009","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1835.55,"maximum":4079,"gross_charge":4079,"discounted_cash":1427.65,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2855.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2651.35,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2651.35,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2855.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2651.35,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2855.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4079,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3059.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2039.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3467.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2243.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2243.45,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1835.55,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2243.45,"methodology":"fee schedule"}]}]},{"description":"HC FINE NEEDLE ASPIRAT DEEP TISS","code_information":[{"code":"10009","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":271,"maximum":5160,"gross_charge":4079,"discounted_cash":1427.65,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2855.3,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":332.89,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":662.69,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":283.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":705.85,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":514.74,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2447.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2855.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2651.35,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2651.35,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2855.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2651.35,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2855.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4079,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3059.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1835.55,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3467.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1917.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":311.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2243.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2243.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":417.34,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1475.79,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3370.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1672.39,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2243.45,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":371.27,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1101.33,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC FNA W/CT 1ST LESION","code_information":[{"code":"10009","type":"CPT"},{"code":"0350","type":"RC"}],"standard_charges":[{"minimum":1600.2,"maximum":3556,"gross_charge":3556,"discounted_cash":1244.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2489.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2311.4,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2311.4,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2489.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2311.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2489.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3556,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2667,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1778,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3022.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1955.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1955.8,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1600.2,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1955.8,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/CT 1ST LESION","code_information":[{"code":"10009","type":"CPT"},{"code":"0350","type":"RC"}],"standard_charges":[{"minimum":271,"maximum":5160,"gross_charge":3556,"discounted_cash":1244.6,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2489.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":590,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":332.89,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":662.69,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":283.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":705.85,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":514.74,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2133.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2489.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2311.4,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2311.4,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":900,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2489.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":800,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":800,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2311.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2489.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1154.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3556,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2667,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1600.2,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3022.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1671.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":311.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1955.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1955.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":417.34,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1286.57,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2937.97,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1457.96,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1955.8,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":371.27,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":960.12,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC FNA W/CT EA ADD LESION","code_information":[{"code":"10010","type":"CPT"},{"code":"0350","type":"RC"}],"standard_charges":[{"minimum":635.4,"maximum":1412,"gross_charge":1412,"discounted_cash":494.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1412,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1059,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":706,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":635.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/CT EA ADD LESION","code_information":[{"code":"10010","type":"CPT"},{"code":"0350","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":2172,"gross_charge":1412,"discounted_cash":494.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":590,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":847.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":900,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":800,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":800,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1154.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1412,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1059,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":635.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":663.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":510.87,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1166.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":578.92,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":381.24,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/MR 1ST LESION","code_information":[{"code":"10011","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":635.4,"maximum":1412,"gross_charge":1412,"discounted_cash":494.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1412,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1059,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":706,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":635.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/MR 1ST LESION","code_information":[{"code":"10011","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":271,"maximum":5160,"gross_charge":1412,"discounted_cash":494.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1023,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":332.89,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":662.69,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":283.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":705.85,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":514.74,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":847.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1398.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1412,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1059,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":635.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":663.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":311.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":417.34,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":510.87,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1166.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":578.92,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":371.27,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":381.24,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC FNA W/MR EA ADD LESION","code_information":[{"code":"10012","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":635.4,"maximum":1412,"gross_charge":1412,"discounted_cash":494.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1412,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1059,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":706,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":635.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/MR EA ADD LESION","code_information":[{"code":"10012","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":2172,"gross_charge":1412,"discounted_cash":494.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1023,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":847.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1100,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1050,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":917.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":988.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1398.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1412,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1059,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":635.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":663.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":510.87,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1166.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":578.92,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":776.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":381.24,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/O IMAGING GND 1ST LES","code_information":[{"code":"10021","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":282.6,"maximum":628,"gross_charge":628,"discounted_cash":219.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":628,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":471,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":314,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":533.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":282.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":345.4,"methodology":"fee schedule"}]}]},{"description":"HC FNA W/O IMAGING GND 1ST LES","code_information":[{"code":"10021","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":54.45,"maximum":2172,"gross_charge":628,"discounted_cash":219.8,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":477.28,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":63.93,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":127.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":54.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":135.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":98.85,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":101.17,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":376.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":376.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":628,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":471,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":282.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":533.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":295.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.18,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":62.63,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":83.87,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":227.22,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":518.86,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":257.48,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":54.46,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":72.98,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":54.46,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":55.55,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":55.55,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":169.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":55.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":74.61,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":169.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":54.46,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":54.46,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":72.98,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":54.46,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":169.56,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC IMAGE GUIDED CATH PLACEMENT","code_information":[{"code":"10030","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":754.65,"maximum":1677,"gross_charge":1677,"discounted_cash":586.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1173.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1090.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1090.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1173.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1090.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1173.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1677,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1257.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":838.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1425.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":922.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":922.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":922.35,"methodology":"fee schedule"}]}]},{"description":"HC IMAGE GUIDED CATH PLACEMENT","code_information":[{"code":"10030","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":140,"maximum":2290.37,"gross_charge":1677,"discounted_cash":586.95,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1173.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1274.52,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":512.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1244.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":561.21,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1342.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":1018.72,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1006.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1173.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1090.05,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1090.05,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1173.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1090.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1173.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1677,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1257.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":1090.05,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":1090.05,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1425.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":788.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":311.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":922.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":922.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":417.34,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":606.74,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1385.54,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":687.57,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":922.35,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":371.27,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":452.79,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC PERQ DEV SOFT TISS 1ST IMAG","code_information":[{"code":"10035","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":1507.5,"maximum":3350,"gross_charge":3350,"discounted_cash":1172.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2345,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2177.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2177.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2345,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2177.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2345,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3350,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2512.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2847.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1842.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1842.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1507.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1842.5,"methodology":"fee schedule"}]}]},{"description":"HC PERQ DEV SOFT TISS 1ST IMAG","code_information":[{"code":"10035","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":507.41,"maximum":7221,"gross_charge":3350,"discounted_cash":1172.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2345,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2546,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":512.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1244.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":561.21,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1342.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":1018.72,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2010,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2345,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2177.5,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2177.5,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2345,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2177.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2345,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3350,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2512.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1507.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2847.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1574.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1842.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1842.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1212.03,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2767.77,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1373.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1842.5,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":904.5,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC PERQ DEV SOFT TISS ADD IMAG","code_information":[{"code":"10036","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":1059.3,"maximum":2354,"gross_charge":2354,"discounted_cash":823.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1647.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1530.1,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1530.1,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1647.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1530.1,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1647.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2354,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1765.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1177,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2000.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1294.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1294.7,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1059.3,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1294.7,"methodology":"fee schedule"}]}]},{"description":"HC PERQ DEV SOFT TISS ADD IMAG","code_information":[{"code":"10036","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":2354,"gross_charge":2354,"discounted_cash":823.9,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1647.8,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1789.04,"methodology":"fee schedule"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1412.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1647.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1530.1,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1530.1,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1647.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1530.1,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1647.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2354,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1765.5,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1059.3,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2000.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1106.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1294.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1294.7,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":851.68,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1944.88,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":965.14,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1294.7,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":635.58,"methodology":"fee schedule"}]}]},{"description":"ACNE SURGERY","code_information":[{"code":"10040","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC I&D ABSC SIMPL OR SGL","code_information":[{"code":"10060","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":152.55,"maximum":339,"gross_charge":339,"discounted_cash":118.65,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":237.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":220.35,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":220.35,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":237.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":220.35,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":237.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":339,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":254.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":169.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":288.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":186.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":186.45,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":152.55,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":186.45,"methodology":"fee schedule"}]}]},{"description":"HC I&D ABSC SIMPL OR SGL","code_information":[{"code":"10060","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":68.44,"maximum":2700,"gross_charge":339,"discounted_cash":118.65,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":237.3,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":257.64,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":81.46,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":162.17,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":69.4,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":172.73,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":125.97,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":88.99,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":203.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":237.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":220.35,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":220.35,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":237.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":220.35,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":203.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":237.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":339,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":254.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":220.35,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":220.35,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":152.55,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":288.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":159.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.86,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.71,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":186.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":186.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":105.4,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":122.66,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":280.09,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":138.99,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":68.44,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":91.71,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":68.44,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":186.45,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":69.81,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":69.81,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":213.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":69.81,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":93.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":213.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":68.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":68.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":91.71,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":68.44,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":91.53,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC I&D ABSCESS COMPL/MULTI","code_information":[{"code":"10061","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":475.65,"maximum":1057,"gross_charge":1057,"discounted_cash":369.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":739.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":687.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":687.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":739.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":687.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":739.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1057,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":792.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":528.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":898.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":581.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":581.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":475.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":581.35,"methodology":"fee schedule"}]}]},{"description":"HC I&D ABSCESS COMPL/MULTI","code_information":[{"code":"10061","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":99.79,"maximum":5160,"gross_charge":1057,"discounted_cash":369.95,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":739.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":803.32,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":124.73,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":248.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":106.25,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":264.47,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":192.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":99.79,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":634.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":739.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":687.05,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":687.05,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":739.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":687.05,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":634.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":739.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1057,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":792.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":687.05,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":687.05,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":475.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":898.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":496.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.56,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":118.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":581.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":581.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":159.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":382.43,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":873.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":433.37,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":103.39,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":138.54,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":103.39,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":581.35,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":105.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":105.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":322.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":105.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":141.64,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":322.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":103.39,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":103.39,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":138.54,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":103.39,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":285.39,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC I&D PILONIDAL CYST SIMPLE","code_information":[{"code":"10080","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":339.75,"maximum":755,"gross_charge":755,"discounted_cash":264.25,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":528.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":490.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":490.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":528.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":490.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":528.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":755,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":566.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":377.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":641.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":415.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":415.25,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":339.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":415.25,"methodology":"fee schedule"}]}]},{"description":"HC I&D PILONIDAL CYST SIMPLE","code_information":[{"code":"10080","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":99.79,"maximum":2700,"gross_charge":755,"discounted_cash":264.25,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":528.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":573.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":178.51,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":355.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":152.07,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":378.51,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":276.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":99.79,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":453,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":528.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":490.75,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":490.75,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":528.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":490.75,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":453,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":528.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":755,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":566.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":490.75,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":490.75,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":339.75,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":641.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":354.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":192.36,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":210.68,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":415.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":415.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":282.13,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":273.16,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":623.79,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":309.55,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":183.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":245.49,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":183.2,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":415.25,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":186.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":186.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":571.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":186.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":250.98,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":571.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":183.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":183.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":245.49,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":183.2,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":203.85,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC I&D PILONIDAL CYST COMPLC","code_information":[{"code":"10081","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1134,"maximum":2520,"gross_charge":2520,"discounted_cash":882,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1764,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1638,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1638,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1764,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1638,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1764,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2520,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1890,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1260,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2142,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1386,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1386,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1134,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1386,"methodology":"fee schedule"}]}]},{"description":"HC I&D PILONIDAL CYST COMPLC","code_information":[{"code":"10081","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":140,"maximum":2700,"gross_charge":2520,"discounted_cash":882,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1764,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1915.2,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":225.29,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":448.49,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":191.91,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":477.69,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":348.36,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":229.74,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1512,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1764,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1638,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1638,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1764,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1638,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1512,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1764,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2520,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1890,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":1638,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":1638,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1134,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2142,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1184.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":231.19,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":253.21,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1386,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1386,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":339.08,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":911.74,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2082.03,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1033.2,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":220.18,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":295.04,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":220.18,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1386,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":224.58,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":224.58,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":686.96,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":224.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":301.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":686.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":220.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":220.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":295.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":220.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":680.4,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"SEIZURES WITHOUT MCC","code_information":[{"code":"101","type":"MS-DRG"}],"standard_charges":[{"minimum":6193.75,"maximum":27957.9,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":13247.75,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":10228,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":13755,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21707,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":12483,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12903.65,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12903.65,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":12043.41,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12903.65,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":7466,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":10968,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":10968,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":11576,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":11613.29,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":27957.9,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":17031,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":17031,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6193.75,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12903.65,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6547,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":12401,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":9210,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":13778,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":13778,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12903.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8774.48,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8602.43,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8860.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8602.43,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8602.43,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8688.46,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":9204.61,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8602.43,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8602.43,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8322.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":10322.92,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":9204.61,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":9032.56,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8774.48,"methodology":"case rate"}]}]},{"description":"HC INC&REMV FOREIGN BODY SMPL","code_information":[{"code":"10120","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":386.1,"maximum":858,"gross_charge":858,"discounted_cash":300.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":600.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":557.7,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":557.7,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":600.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":557.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":600.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":858,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":643.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":429,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":729.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":386.1,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":471.9,"methodology":"fee schedule"}]}]},{"description":"HC INC&REMV FOREIGN BODY SMPL","code_information":[{"code":"10120","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":90.87,"maximum":2700,"gross_charge":858,"discounted_cash":300.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":600.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":652.08,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":115.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":229.68,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":98.28,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":244.64,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":178.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":124.97,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":514.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":600.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":557.7,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":557.7,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":600.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":557.7,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":514.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":600.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":858,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":643.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":557.7,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":557.7,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":386.1,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":729.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":403.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":95.41,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":104.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":139.94,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":310.43,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":708.88,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":351.78,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":121.77,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":471.9,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":92.69,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":92.69,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":283.51,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":92.69,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":124.49,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":283.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":121.77,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":231.66,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"REMOVE FOREIGN BODY","code_information":[{"code":"10121","type":"CPT"}],"standard_charges":[{"minimum":511.75,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1152.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2800.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1262.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3019.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2292.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1837.8,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":588.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":788.1,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":701.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"HC I&D HEMATOMA FLUID","code_information":[{"code":"10140","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":1215,"maximum":2700,"gross_charge":2700,"discounted_cash":945,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1890,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1755,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1755,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1890,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1755,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1890,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2025,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1350,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2295,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1485,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1485,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1215,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1485,"methodology":"fee schedule"}]}]},{"description":"HC I&D HEMATOMA FLUID","code_information":[{"code":"10140","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":95.53,"maximum":5274.3,"gross_charge":2700,"discounted_cash":945,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1890,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2052,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":118.88,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":236.65,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":101.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":252.06,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":183.82,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":132.55,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1620,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1890,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1755,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1755,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1890,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1755,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1620,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1890,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2025,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":1755,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":1755,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1215,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2295,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1269,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":100.31,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":109.86,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1485,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1485,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":147.12,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":976.86,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2230.74,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1107,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":95.53,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":128.01,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":95.53,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1485,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":97.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":97.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":298.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":97.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":130.88,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":298.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":95.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":95.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":128.01,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":95.53,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":729,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"HC I&D PUNCTURE ASPIRATION","code_information":[{"code":"10160","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":221.4,"maximum":492,"gross_charge":492,"discounted_cash":172.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":344.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":319.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":319.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":344.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":319.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":344.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":492,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":369,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":246,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":418.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":270.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":270.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":221.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":270.6,"methodology":"fee schedule"}]}]},{"description":"HC I&D PUNCTURE ASPIRATION","code_information":[{"code":"10160","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":71.36,"maximum":2700,"gross_charge":492,"discounted_cash":172.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":344.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":373.92,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":90.04,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":179.25,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":76.7,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":190.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":139.23,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":99.79,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":295.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":344.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":319.8,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":319.8,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":344.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":319.8,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":295.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":344.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":492,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":369,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":319.8,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":319.8,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":221.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":418.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":231.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.93,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":82.06,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":270.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":270.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":109.89,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":178.01,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":406.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":201.72,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":71.36,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":95.62,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":71.36,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":270.6,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":72.79,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":72.79,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":222.64,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":72.79,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":97.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":222.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":71.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":71.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":95.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":71.36,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":132.84,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"COMPLEX DRAINAGE WOUND","code_information":[{"code":"10180","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2241.24,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"HEADACHES WITH MCC","code_information":[{"code":"102","type":"MS-DRG"}],"standard_charges":[{"minimum":7523.17,"maximum":33958.73,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":16091.22,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13046,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":17303,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":27307,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":15703,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15673.26,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":15673.26,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":14628.38,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":15673.26,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":9392,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":13798,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":13798,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":14562,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":14105.94,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":33958.73,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":21425,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":21425,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":7523.17,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":15673.26,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8685,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":15601,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":11586,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":17332,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":17332,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":15673.26,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10657.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10448.84,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":10762.31,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":10448.84,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":10448.84,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":10553.33,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":11180.26,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10448.84,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10448.84,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":10109.26,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":12538.61,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":11180.26,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":10971.29,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":10657.82,"methodology":"case rate"}]}]},{"description":"HEADACHES WITHOUT MCC","code_information":[{"code":"103","type":"MS-DRG"}],"standard_charges":[{"minimum":5794.03,"maximum":26153.6,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":12392.79,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9445,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":12688,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20023,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":11514,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12070.89,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":12070.89,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":11266.17,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":12070.89,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":6887,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":10117,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":10117,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":10678,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":10863.81,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":26153.6,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":15710,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":15710,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5794.03,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12070.89,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6064,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":11439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":8495,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":12709,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":12709,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":12070.89,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8208.21,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8047.26,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8288.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":8047.26,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":8047.26,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":8127.74,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8610.57,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8047.26,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":8047.26,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":7785.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9656.72,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8610.57,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8449.63,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8208.21,"methodology":"case rate"}]}]},{"description":"HC DEBR EXZ/INF SKIN TO 10%","code_information":[{"code":"11000","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":666,"maximum":1480,"gross_charge":1480,"discounted_cash":518,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1480,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1110,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":740,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1258,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":666,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"}]}]},{"description":"HC DEBR EXZ/INF SKIN TO 10%","code_information":[{"code":"11000","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":31.45,"maximum":2700,"gross_charge":1480,"discounted_cash":518,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1124.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":37.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":73.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":31.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":78.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":57.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":42.93,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":888,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":888,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1480,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1110,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":666,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1258,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":695.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.02,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":36.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":48.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":535.47,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1222.78,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":606.8,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":31.45,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":42.14,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":31.45,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":32.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":32.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":98.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":32.08,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":43.09,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":98.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":31.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":31.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":42.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":31.45,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":399.6,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC DEBR EXZ/INF SKIN EA AD+10%","code_information":[{"code":"11001","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":82.8,"maximum":184,"gross_charge":184,"discounted_cash":64.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":128.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":128.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":128.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":184,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":138,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":92,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":156.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":101.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":101.2,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":82.8,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":101.2,"methodology":"fee schedule"}]}]},{"description":"HC DEBR EXZ/INF SKIN EA AD+10%","code_information":[{"code":"11001","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":14.53,"maximum":2700,"gross_charge":184,"discounted_cash":64.4,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":128.8,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":139.84,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":14.53,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":110.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":128.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":128.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":110.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":128.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":184,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":138,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":82.8,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":156.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":86.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":21.26,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20.24,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":101.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":101.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":27.13,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":66.58,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":152.03,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":75.44,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20.24,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":27.13,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":20.24,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":101.2,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":20.65,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":20.65,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":63.15,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20.65,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":27.73,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":63.15,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20.24,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":20.24,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":27.13,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":20.24,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":49.68,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE GENITALIA  PERINEUM","code_information":[{"code":"11004","type":"CPT"}],"standard_charges":[{"minimum":403,"maximum":9158,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":649.61,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1293.2,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":553.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1377.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":403,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1388.57,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"DEBRIDE ABDOM WALL","code_information":[{"code":"11005","type":"CPT"}],"standard_charges":[{"minimum":546.67,"maximum":9158,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":881.2,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1754.25,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":750.66,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1868.48,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":546.67,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1706.67,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"DEBRIDE GENIT/PER/ABDOM WALL","code_information":[{"code":"11006","type":"CPT"}],"standard_charges":[{"minimum":493.55,"maximum":9158,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":795.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1583.78,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":677.71,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1686.91,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":493.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1632.82,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"REMOVE MESH FROM ABD WALL","code_information":[{"code":"11008","type":"CPT"}],"standard_charges":[{"minimum":192.2,"maximum":9158,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":309.82,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":616.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":263.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":656.93,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":192.2,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":694.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9158,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3309,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1101","type":"APR-DRG"}],"standard_charges":[{"minimum":3256,"maximum":12047.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3418.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3744.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8986.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3256,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7814.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3256,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3321.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3321.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12047.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3321.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7977.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12047.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3353.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3353.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8042.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3353.68,"methodology":"case rate"}]}]},{"description":"DEBRIDE SKIN AT FX SITE","code_information":[{"code":"11010","type":"CPT"}],"standard_charges":[{"minimum":271,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":512.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1244.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":561.21,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1342.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":1018.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":517.46,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":311.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":417.34,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":371.27,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"DEBRIDE SKIN MUSC AT FX SITE","code_information":[{"code":"11011","type":"CPT"}],"standard_charges":[{"minimum":271,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":512.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1244.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":561.21,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1342.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":1018.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":517.46,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":311.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":417.34,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":371.27,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC DEB SKIN BONE AT FX SITE","code_information":[{"code":"11012","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":3012.3,"maximum":6694,"gross_charge":6694,"discounted_cash":2342.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4685.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4351.1,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4351.1,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4685.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4351.1,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4685.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":6694,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5020.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3347,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":5689.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3681.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3681.7,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3012.3,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3681.7,"methodology":"fee schedule"}]}]},{"description":"HC DEB SKIN BONE AT FX SITE","code_information":[{"code":"11012","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":517.46,"maximum":9316.74,"gross_charge":6694,"discounted_cash":2342.9,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4685.8,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":5087.44,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":517.46,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":4016.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4685.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4351.1,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4351.1,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4685.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4351.1,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4685.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":6694,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5020.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3012.3,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":5689.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3146.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3681.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3681.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2421.89,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5530.59,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2744.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3681.7,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1807.38,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1102","type":"APR-DRG"}],"standard_charges":[{"minimum":5215,"maximum":19295.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5475.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5997.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":14393.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5215,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12516,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5215,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5319.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5319.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19295.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5319.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12776.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19295.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5371.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5371.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12881.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5371.45,"methodology":"case rate"}]}]},{"description":"EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1103","type":"APR-DRG"}],"standard_charges":[{"minimum":5609,"maximum":20753.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5889.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6450.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":15480.84,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5609,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":13461.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5609,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5721.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5721.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":20753.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5721.18,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":13742.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":20753.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5777.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5777.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":13854.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5777.27,"methodology":"case rate"}]}]},{"description":"EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1104","type":"APR-DRG"}],"standard_charges":[{"minimum":10345,"maximum":38276.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":10862.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11896.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":28552.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10345,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":24828,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10345,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10551.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10551.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":38276.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10551.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":25345.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":38276.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10655.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":10655.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":25552.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10655.35,"methodology":"case rate"}]}]},{"description":"HC DEB SQ TISS IST 20SQCM/<","code_information":[{"code":"11042","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":1000.35,"maximum":2223,"gross_charge":2223,"discounted_cash":778.05,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1556.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1444.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1444.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1556.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1444.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1556.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2223,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1667.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1111.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1889.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1222.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1222.65,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1000.35,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1222.65,"methodology":"fee schedule"}]}]},{"description":"HC DEB SQ TISS IST 20SQCM/<","code_information":[{"code":"11042","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"gross_charge":2223,"discounted_cash":778.05,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1556.1,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1689.48,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":315.46,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1333.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1556.1,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1444.95,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1444.95,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1556.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1444.95,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1556.1,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2223,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1667.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1000.35,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1889.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1044.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1222.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1222.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":804.29,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1836.65,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":911.43,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1222.65,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":600.21,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC DEB MUSC/FASC 20SQCM/<","code_information":[{"code":"11043","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":2542.05,"maximum":5649,"gross_charge":5649,"discounted_cash":1977.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3954.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3671.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3671.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3954.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3671.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3954.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5649,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4236.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2824.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4801.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3106.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3106.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2542.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3106.95,"methodology":"fee schedule"}]}]},{"description":"HC DEB MUSC/FASC 20SQCM/<","code_information":[{"code":"11043","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":228.07,"maximum":7221,"gross_charge":5649,"discounted_cash":1977.15,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3954.3,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":4293.24,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":315.46,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3389.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3954.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3671.85,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3671.85,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3954.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3671.85,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3954.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5649,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4236.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2542.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4801.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2655.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3106.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3106.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2043.81,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4667.21,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2316.09,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3106.95,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1525.23,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC DEB BONE 20SQCM/<","code_information":[{"code":"11044","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":3799.35,"maximum":8443,"gross_charge":8443,"discounted_cash":2955.05,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5910.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5487.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5487.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5910.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5487.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5910.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":8443,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6332.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":4221.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7176.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4643.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4643.65,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3799.35,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4643.65,"methodology":"fee schedule"}]}]},{"description":"HC DEB BONE 20SQCM/<","code_information":[{"code":"11044","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":511.75,"maximum":8443,"gross_charge":8443,"discounted_cash":2955.05,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5910.1,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":6416.68,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1152.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2800.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1262.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3019.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2292.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":835.42,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":5065.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5910.1,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5487.95,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5487.95,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5910.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5487.95,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5910.1,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":8443,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6332.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3799.35,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7176.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3968.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":588.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4643.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4643.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":788.1,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3054.68,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6975.61,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3461.63,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4643.65,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":701.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2279.61,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"HC DEB SQ TISS ADD 20SQCM<","code_information":[{"code":"11045","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":432,"maximum":960,"gross_charge":960,"discounted_cash":336,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":672,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":624,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":624,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":672,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":624,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":672,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":960,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":720,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":480,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":816,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":528,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":528,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":432,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":528,"methodology":"fee schedule"}]}]},{"description":"HC DEB SQ TISS ADD 20SQCM<","code_information":[{"code":"11045","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":2700,"gross_charge":960,"discounted_cash":336,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":672,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":729.6,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":52,"standard_charge_algorithm": "Lesser of $52.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":64,"standard_charge_algorithm": "Lesser of $64.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":32,"standard_charge_algorithm": "Lesser of $32.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":70,"standard_charge_algorithm": "Lesser of $70.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":49,"standard_charge_algorithm": "Lesser of $49.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":329.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":576,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":672,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":624,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":624,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":672,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":624,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":576,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":672,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":960,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":720,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":624,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":624,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":432,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":816,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":451.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":528,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":528,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":347.33,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":793.16,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":393.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":528,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":259.2,"methodology":"fee schedule"}]}]},{"description":"HC DEB MUSC/FAS + 20SQCM<","code_information":[{"code":"11046","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":885.6,"maximum":1968,"gross_charge":1968,"discounted_cash":688.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1377.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1279.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1279.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1377.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1279.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1377.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1968,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1476,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":984,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1672.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1082.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1082.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":885.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1082.4,"methodology":"fee schedule"}]}]},{"description":"HC DEB MUSC/FAS + 20SQCM<","code_information":[{"code":"11046","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":2700,"gross_charge":1968,"discounted_cash":688.8,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1377.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1495.68,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":52,"standard_charge_algorithm": "Lesser of $52.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":64,"standard_charge_algorithm": "Lesser of $64.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":32,"standard_charge_algorithm": "Lesser of $32.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":70,"standard_charge_algorithm": "Lesser of $70.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":49,"standard_charge_algorithm": "Lesser of $49.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":329.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1180.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1377.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1279.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1279.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1377.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1279.2,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1180.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1377.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1968,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1476,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":1279.2,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":1279.2,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":885.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1672.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":924.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1082.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1082.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":712.03,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1625.97,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":806.88,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1082.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":531.36,"methodology":"fee schedule"}]}]},{"description":"HC DEB BONE(5) ADDL 20SQCM","code_information":[{"code":"11047","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":1569.15,"maximum":3487,"gross_charge":3487,"discounted_cash":1220.45,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2440.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2266.55,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2266.55,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2440.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2266.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2440.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3487,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2615.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1743.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2963.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1917.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1917.85,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1569.15,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1917.85,"methodology":"fee schedule"}]}]},{"description":"HC DEB BONE(5) ADDL 20SQCM","code_information":[{"code":"11047","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":3487,"gross_charge":3487,"discounted_cash":1220.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2440.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2650.12,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":52,"standard_charge_algorithm": "Lesser of $52.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":64,"standard_charge_algorithm": "Lesser of $64.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":32,"standard_charge_algorithm": "Lesser of $32.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":70,"standard_charge_algorithm": "Lesser of $70.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":49,"standard_charge_algorithm": "Lesser of $49.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1023.68,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2092.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2440.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2266.55,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2266.55,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2440.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2266.55,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":2092.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2440.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3487,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2615.25,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":2266.55,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":2266.55,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1569.15,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2963.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1638.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1917.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1917.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1261.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2880.96,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1429.67,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1917.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":941.49,"methodology":"fee schedule"}]}]},{"description":"HC PARE BENIGN LESION;SGL","code_information":[{"code":"11055","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":187.65,"maximum":417,"gross_charge":417,"discounted_cash":145.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":291.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":271.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":271.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":291.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":271.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":291.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":417,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":312.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":208.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":354.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":229.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":229.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":187.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":229.35,"methodology":"fee schedule"}]}]},{"description":"HC PARE BENIGN LESION;SGL","code_information":[{"code":"11055","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":46.08,"maximum":2700,"gross_charge":417,"discounted_cash":145.95,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":291.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":316.92,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":46.08,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":250.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":291.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":271.05,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":271.05,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":291.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":271.05,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":250.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":291.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":417,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":312.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":271.05,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":271.05,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":187.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":354.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":195.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":229.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":229.35,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":150.88,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":344.53,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":170.97,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":229.35,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":112.59,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC PARE BENIGN LESION;2-4 LES","code_information":[{"code":"11056","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":265.5,"maximum":590,"gross_charge":590,"discounted_cash":206.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":413,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":383.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":383.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":413,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":383.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":413,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":590,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":442.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":295,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":501.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":324.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":324.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":265.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":324.5,"methodology":"fee schedule"}]}]},{"description":"HC PARE BENIGN LESION;2-4 LES","code_information":[{"code":"11056","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":50.49,"maximum":2700,"gross_charge":590,"discounted_cash":206.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":413,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":448.4,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":50.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":354,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":413,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":383.5,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":383.5,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":413,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":383.5,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":354,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":413,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":590,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":442.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":383.5,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":383.5,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":265.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":501.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":277.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":324.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":324.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":213.47,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":487.46,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":241.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":324.5,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":159.3,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC PARE BENIGN LESION;>4 LES","code_information":[{"code":"11057","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":347.4,"maximum":772,"gross_charge":772,"discounted_cash":270.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":540.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":501.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":501.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":540.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":501.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":540.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":772,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":579,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":386,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":656.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":424.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":424.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":347.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":424.6,"methodology":"fee schedule"}]}]},{"description":"HC PARE BENIGN LESION;>4 LES","code_information":[{"code":"11057","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":53.45,"maximum":2700,"gross_charge":772,"discounted_cash":270.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":540.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":586.72,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":62.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":124.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":53.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":133.05,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":97.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":463.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":540.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":501.8,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":501.8,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":540.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":501.8,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":463.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":540.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":772,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":579,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":501.8,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":501.8,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":347.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":656.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":362.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":61.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":67.32,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":424.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":424.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":90.15,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":279.31,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":637.83,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":316.52,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":58.54,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":78.44,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":58.54,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":424.6,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":59.71,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":59.71,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":182.64,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":59.71,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":80.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":182.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":58.54,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":58.54,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":78.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":58.54,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":208.44,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC TANGNTL BX SKIN SINGLE LES","code_information":[{"code":"11102","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":367.65,"maximum":817,"gross_charge":817,"discounted_cash":285.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":571.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":531.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":531.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":571.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":531.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":571.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":817,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":612.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":408.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":694.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":449.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":449.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":367.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":449.35,"methodology":"fee schedule"}]}]},{"description":"HC TANGNTL BX SKIN SINGLE LES","code_information":[{"code":"11102","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":67.57,"maximum":2172,"gross_charge":817,"discounted_cash":285.95,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":571.9,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":81.85,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":162.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":69.73,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":173.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":126.57,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":490.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":571.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":531.05,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":531.05,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":571.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":531.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":571.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":817,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":612.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":571.9,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":531.05,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":367.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":694.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":383.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":70.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":77.71,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":449.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":449.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":104.06,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":295.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":675.01,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":334.97,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":90.54,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":449.35,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":68.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":68.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":210.82,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":68.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":92.57,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":210.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":90.54,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":220.59,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC TANGNTL BX SKIN EA SEP/ADDL","code_information":[{"code":"11103","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":213.75,"maximum":475,"gross_charge":475,"discounted_cash":166.25,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":308.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":308.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":308.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":475,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":356.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":237.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":403.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":213.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":261.25,"methodology":"fee schedule"}]}]},{"description":"HC TANGNTL BX SKIN EA SEP/ADDL","code_information":[{"code":"11103","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":2172,"gross_charge":475,"discounted_cash":166.25,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":52,"standard_charge_algorithm": "Lesser of $52.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":64,"standard_charge_algorithm": "Lesser of $64.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":32,"standard_charge_algorithm": "Lesser of $32.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":70,"standard_charge_algorithm": "Lesser of $70.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":49,"standard_charge_algorithm": "Lesser of $49.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":285,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":308.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":308.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":308.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":475,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":356.25,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":308.75,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":213.75,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":403.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":223.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":171.86,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":392.45,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":194.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":128.25,"methodology":"fee schedule"}]}]},{"description":"HC PUNCH BX SKIN SINGLE LESION","code_information":[{"code":"11104","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":455.85,"maximum":1013,"gross_charge":1013,"discounted_cash":354.55,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":709.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":658.45,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":658.45,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":709.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":658.45,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":709.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1013,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":759.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":506.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":861.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":557.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":557.15,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":455.85,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":557.15,"methodology":"fee schedule"}]}]},{"description":"HC PUNCH BX SKIN SINGLE LESION","code_information":[{"code":"11104","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":81.23,"maximum":2172,"gross_charge":1013,"discounted_cash":354.55,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":709.1,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":95.35,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":189.82,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":81.23,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":202.18,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":147.44,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":607.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":709.1,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":658.45,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":658.45,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":709.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":658.45,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":709.1,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1013,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":759.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":709.1,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":658.45,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":455.85,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":861.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":476.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.77,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":96.13,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":557.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":557.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":128.73,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":366.51,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":836.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":415.33,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":83.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":112.01,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":83.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":557.15,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":85.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":85.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":260.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":85.26,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":114.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":260.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":83.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":83.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":112.01,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":83.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":273.51,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC PUNCH BX SKIN EA SEP/ADDL","code_information":[{"code":"11105","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":248.85,"maximum":553,"gross_charge":553,"discounted_cash":193.55,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":387.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":359.45,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":359.45,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":387.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":359.45,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":387.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":553,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":414.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":276.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":470.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":304.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":304.15,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":248.85,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":304.15,"methodology":"fee schedule"}]}]},{"description":"HC PUNCH BX SKIN EA SEP/ADDL","code_information":[{"code":"11105","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":2172,"gross_charge":553,"discounted_cash":193.55,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":387.1,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":52,"standard_charge_algorithm": "Lesser of $52.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":64,"standard_charge_algorithm": "Lesser of $64.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":32,"standard_charge_algorithm": "Lesser of $32.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":70,"standard_charge_algorithm": "Lesser of $70.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":49,"standard_charge_algorithm": "Lesser of $49.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":331.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":387.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":359.45,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":359.45,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":387.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":359.45,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":387.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":553,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":414.75,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":387.1,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":359.45,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":248.85,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":470.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":259.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":304.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":304.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":200.08,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":456.89,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":226.73,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":304.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":149.31,"methodology":"fee schedule"}]}]},{"description":"HC INCAL BX SKIN SINGLE LES","code_information":[{"code":"11106","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":549.9,"maximum":1222,"gross_charge":1222,"discounted_cash":427.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":855.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":794.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":794.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":855.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":794.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":855.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1222,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":916.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":611,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1038.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":672.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":672.1,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":549.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":672.1,"methodology":"fee schedule"}]}]},{"description":"HC INCAL BX SKIN SINGLE LES","code_information":[{"code":"11106","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":100,"maximum":5160,"gross_charge":1222,"discounted_cash":427.7,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":855.4,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":125.51,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":249.85,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":106.91,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":266.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":194.07,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":733.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":855.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":794.3,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":794.3,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":855.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":794.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":855.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1222,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":916.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":855.4,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":794.3,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":549.9,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1038.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":574.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":119.57,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":672.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":672.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":160.11,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":442.12,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1009.62,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":501.02,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":103.97,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":139.32,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":103.97,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":672.1,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":106.05,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":106.05,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":324.39,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":106.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":142.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":324.39,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":103.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":103.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":139.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":103.97,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":329.94,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC INCAL BX SKIN EA SEP/ADDL","code_information":[{"code":"11107","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":298.35,"maximum":663,"gross_charge":663,"discounted_cash":232.05,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":464.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":430.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":430.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":464.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":430.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":464.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":663,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":497.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":331.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":563.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":364.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":364.65,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":298.35,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":364.65,"methodology":"fee schedule"}]}]},{"description":"HC INCAL BX SKIN EA SEP/ADDL","code_information":[{"code":"11107","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":2172,"gross_charge":663,"discounted_cash":232.05,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":464.1,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":52,"standard_charge_algorithm": "Lesser of $52.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":64,"standard_charge_algorithm": "Lesser of $64.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":32,"standard_charge_algorithm": "Lesser of $32.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":70,"standard_charge_algorithm": "Lesser of $70.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":49,"standard_charge_algorithm": "Lesser of $49.00 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":397.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":464.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":430.95,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":430.95,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":464.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":430.95,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":464.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":663,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":497.25,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":464.1,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":430.95,"methodology":"fee schedule"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":298.35,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":563.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":311.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":364.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":364.65,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":239.88,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":547.78,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":271.83,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":364.65,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":179.01,"methodology":"fee schedule"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1111","type":"APR-DRG"}],"standard_charges":[{"minimum":2427,"maximum":8979.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2548.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2791.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6698.52,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2427,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5824.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2427,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2475.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2475.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8979.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2475.54,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5946.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8979.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2499.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2499.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5994.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2499.81,"methodology":"case rate"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1112","type":"APR-DRG"}],"standard_charges":[{"minimum":3324,"maximum":12298.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3490.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3822.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":9174.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3324,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7977.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3324,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3390.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3390.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12298.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3390.48,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8143.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12298.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3423.72,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3423.72,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8210.28,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3423.72,"methodology":"case rate"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1113","type":"APR-DRG"}],"standard_charges":[{"minimum":3935,"maximum":14559.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4131.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4525.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10860.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3935,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9444,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3935,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4013.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4013.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14559.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4013.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9640.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14559.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4053.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4053.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9719.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4053.05,"methodology":"case rate"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1114","type":"APR-DRG"}],"standard_charges":[{"minimum":6500,"maximum":24050,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6825,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7475,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":17940,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6500,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":15600,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6500,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6630,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6630,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24050,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6630,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":15925,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24050,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6695,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6695,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16055,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6695,"methodology":"case rate"}]}]},{"description":"HC REM SKIN TAGS <=15 LESIONS","code_information":[{"code":"11200","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":95.4,"maximum":212,"gross_charge":212,"discounted_cash":74.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":148.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":137.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":137.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":148.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":137.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":148.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":212,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":159,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":106,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":180.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":116.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":116.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":95.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":116.6,"methodology":"fee schedule"}]}]},{"description":"HC REM SKIN TAGS <=15 LESIONS","code_information":[{"code":"11200","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":23.32,"maximum":2700,"gross_charge":212,"discounted_cash":74.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":148.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":161.12,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":127.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":148.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":137.8,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":137.8,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":148.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":137.8,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":127.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":148.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":212,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":159,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":137.8,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":137.8,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":95.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":180.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":99.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":24.49,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23.32,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":116.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":116.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":31.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":76.71,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":175.16,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":86.92,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23.32,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":31.25,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23.32,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":116.6,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":23.79,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23.79,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":72.76,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23.79,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":31.95,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":72.76,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":23.32,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":23.32,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":31.25,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":23.32,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":57.24,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"REMOVE SKIN TAGS ADD-ON","code_information":[{"code":"11201","type":"CPT"}],"standard_charges":[{"minimum":10.1,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":10.1,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ORBITAL PROCEDURES WITH CC/MCC","code_information":[{"code":"113","type":"MS-DRG"}],"standard_charges":[{"minimum":13656.49,"maximum":61643.86,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":29209.71,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":25473,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":33675,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":53145,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":30561,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28451.01,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":28451.01,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":26554.28,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":28451.01,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":18278,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":26854,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":26854,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":28341,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":25605.91,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":61643.86,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":41697,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":41697,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":13656.49,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":28451.01,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":18048,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":30363,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":22548,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":33732,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":33732,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":28451.01,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":19346.69,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18967.34,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":19536.37,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":18967.34,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":18967.34,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":19157.02,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":20295.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18967.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18967.34,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":18350.91,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":22760.81,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":20295.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":19915.71,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":19346.69,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 0.5 CM/<","code_information":[{"code":"11300","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC SHAVE SKIN LES 6-10MM T/A/L","code_information":[{"code":"11301","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":184.95,"maximum":411,"gross_charge":411,"discounted_cash":143.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":411,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":205.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":349.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":184.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":226.05,"methodology":"fee schedule"}]}]},{"description":"HC SHAVE SKIN LES 6-10MM T/A/L","code_information":[{"code":"11301","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"gross_charge":411,"discounted_cash":143.85,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":312.36,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":246.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":246.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":287.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":411,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":267.15,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":184.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":349.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":193.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":148.7,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":339.57,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":168.51,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":226.05,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":110.97,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 1.1-2.0 CM","code_information":[{"code":"11302","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION >2.0 CM","code_information":[{"code":"11303","type":"CPT"}],"standard_charges":[{"minimum":107.15,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":107.15,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 0.5 CM/<","code_information":[{"code":"11305","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 0.6-1.0 CM","code_information":[{"code":"11306","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 1.1-2.0 CM","code_information":[{"code":"11307","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":95.35,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":189.82,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":81.23,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":202.18,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":147.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.12,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":89.94,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":120.44,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":107.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION >2.0 CM","code_information":[{"code":"11308","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1131","type":"APR-DRG"}],"standard_charges":[{"minimum":1448,"maximum":5357.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":1520.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1665.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":3996.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1448,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":3475.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1448,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1476.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1476.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5357.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1476.96,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":3547.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5357.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1491.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":1491.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":3576.56,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1491.44,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 0.5 CM/<","code_information":[{"code":"11310","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":93.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":186.23,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":79.69,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":198.36,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":144.66,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":87.08,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":116.61,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":75.72,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":101.46,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":75.72,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":77.23,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":77.23,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":236.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":77.23,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":103.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":236.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":75.72,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":75.72,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":101.46,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":75.72,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 0.6-1.0 CM","code_information":[{"code":"11311","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":95.35,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":189.82,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":81.23,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":202.18,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":147.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.12,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":89.94,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":120.44,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":107.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 1.1-2.0 CM","code_information":[{"code":"11312","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":120.05,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":238.99,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":102.27,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":254.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":185.64,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.77,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":108.18,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":144.87,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":94.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":126.05,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":94.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":95.95,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":95.95,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":293.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":95.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":128.88,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":293.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":94.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":94.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":126.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":94.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION >2.0 CM","code_information":[{"code":"11313","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":132.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":264.6,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":113.22,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":281.83,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":205.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.87,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":119.24,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":159.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":103.69,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":138.94,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":103.69,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":105.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":105.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":323.51,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":105.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":142.06,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":323.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":103.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":103.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":138.94,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":103.69,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1132","type":"APR-DRG"}],"standard_charges":[{"minimum":2195,"maximum":8121.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2304.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2524.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6058.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2195,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5268,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2195,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2238.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2238.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8121.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2238.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5377.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8121.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2260.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2260.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5421.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2260.85,"methodology":"case rate"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1133","type":"APR-DRG"}],"standard_charges":[{"minimum":6538,"maximum":24190.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6864.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7518.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":18044.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6538,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":15691.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6538,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6668.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6668.76,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24190.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6668.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":16018.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24190.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6734.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6734.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16148.86,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6734.14,"methodology":"case rate"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1134","type":"APR-DRG"}],"standard_charges":[{"minimum":10571,"maximum":39112.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11099.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12156.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":29175.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10571,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":25370.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10571,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10782.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10782.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":39112.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10782.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":25898.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":39112.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10888.13,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":10888.13,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":26110.37,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10888.13,"methodology":"case rate"}]}]},{"description":"ORBITAL PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"114","type":"MS-DRG"}],"standard_charges":[{"minimum":7649.52,"maximum":34529.04,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":16361.46,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":14780,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":17640,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":27840,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":16009,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15936.48,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":15936.48,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":14874.05,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":15936.48,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":9575,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":14067,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":14067,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":14846,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":14342.84,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":34529.04,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":21843,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":21843,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":7649.52,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":15936.48,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8866,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":15905,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":11812,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":17670,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":17670,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":15936.48,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10836.81,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10624.32,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":10943.05,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":10624.32,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":10624.32,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":10730.57,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":11368.03,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10624.32,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10624.32,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":10279.03,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":12749.19,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":11368.03,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":11155.54,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":10836.81,"methodology":"case rate"}]}]},{"description":"HC EXC TR-EXT B9+MARG 0.5CM/<","code_information":[{"code":"11400","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":528.75,"maximum":1175,"gross_charge":1175,"discounted_cash":411.25,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":822.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":763.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":763.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":822.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":763.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":822.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1175,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":881.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":587.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":998.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":646.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":646.25,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":528.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":646.25,"methodology":"fee schedule"}]}]},{"description":"HC EXC TR-EXT B9+MARG 0.5CM/<","code_information":[{"code":"11400","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":81.84,"maximum":5160,"gross_charge":1175,"discounted_cash":411.25,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":822.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":893,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":99.78,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":198.64,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":85,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":211.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":154.29,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":120.56,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":705,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":822.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":763.75,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":763.75,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":822.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":763.75,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":705,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":822.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1175,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":881.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":763.75,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":763.75,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":528.75,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":998.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":552.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.93,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":94.12,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":646.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":646.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":126.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":425.12,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":970.79,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":481.75,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":81.84,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":109.67,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":81.84,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":646.25,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":83.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":83.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":255.34,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":83.48,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":112.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":255.34,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":81.84,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":81.84,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":109.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":81.84,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":317.25,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC EXC TR-EXT B9+MARG 0.6-1 CM","code_information":[{"code":"11401","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":434.25,"maximum":965,"gross_charge":965,"discounted_cash":337.75,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":675.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":627.25,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":627.25,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":675.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":627.25,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":675.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":965,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":723.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":482.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":820.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":530.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":530.75,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":434.25,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":530.75,"methodology":"fee schedule"}]}]},{"description":"HC EXC TR-EXT B9+MARG 0.6-1 CM","code_information":[{"code":"11401","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":93.78,"maximum":5160,"gross_charge":965,"discounted_cash":337.75,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":675.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":733.4,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":113.81,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":226.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":96.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":241.32,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":175.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":135.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":579,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":675.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":627.25,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":627.25,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":675.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":627.25,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":579,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":675.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":965,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":723.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":627.25,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":627.25,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":434.25,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":820.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":453.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":107.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":530.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":530.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":144.42,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":349.14,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":797.29,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":395.65,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":93.78,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":125.67,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":93.78,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":530.75,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":95.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":95.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":292.59,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":95.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":128.48,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":292.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":93.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":93.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":125.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":93.78,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":260.55,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC EXC SKIN BENING 1.1-2CM T/L/A","code_information":[{"code":"11402","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":630.9,"maximum":1402,"gross_charge":1402,"discounted_cash":490.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":981.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":911.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":911.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":981.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":911.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":981.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1402,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1051.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":701,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1191.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":771.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":771.1,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":630.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":771.1,"methodology":"fee schedule"}]}]},{"description":"HC EXC SKIN BENING 1.1-2CM T/L/A","code_information":[{"code":"11402","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":101.64,"maximum":5160,"gross_charge":1402,"discounted_cash":490.7,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":981.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1065.52,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":124.34,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":247.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":105.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":263.65,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":192.27,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":148.96,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":841.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":981.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":911.3,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":911.3,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":981.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":911.3,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":841.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":981.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1402,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1051.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":911.3,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":911.3,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":630.9,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1191.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":658.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":106.72,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":116.89,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":771.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":771.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":156.53,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":507.25,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1158.34,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":574.82,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":101.64,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":136.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":101.64,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":771.1,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":103.67,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":103.67,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":317.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":103.67,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":139.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":317.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":101.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":101.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":136.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":101.64,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":378.54,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC EXC TR-EXT B9+MARG 2.1-3CM","code_information":[{"code":"11403","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":756,"maximum":1680,"gross_charge":1680,"discounted_cash":588,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1176,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1092,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1092,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1176,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1092,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1176,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1680,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1260,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":840,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1428,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":924,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":924,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":756,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":924,"methodology":"fee schedule"}]}]},{"description":"HC EXC TR-EXT B9+MARG 2.1-3CM","code_information":[{"code":"11403","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":110.67,"maximum":5160,"gross_charge":1680,"discounted_cash":588,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1176,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1276.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":134.86,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":268.47,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":114.88,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":285.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":208.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":159.06,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1008,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1176,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1092,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1092,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1176,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1092,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1008,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1176,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1680,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1260,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":1092,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":1092,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":756,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1428,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":789.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":116.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":127.27,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":924,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":924,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":170.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":607.83,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1388.02,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":688.8,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":148.3,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":924,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":112.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":112.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":345.29,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":112.88,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":151.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":345.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":148.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":453.6,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC TR-EXT B9+MARG 3.1-4 CM","code_information":[{"code":"11404","type":"CPT"}],"standard_charges":[{"minimum":511.75,"maximum":5274.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1152.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2800.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1262.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3019.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2292.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1837.8,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":958,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":588.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":788.1,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":701.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC TR-EXT B9+MARG >4.0 CM","code_information":[{"code":"11406","type":"CPT"}],"standard_charges":[{"minimum":511.75,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1152.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2800.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1262.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3019.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2292.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1837.8,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":588.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":788.1,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":701.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1141","type":"APR-DRG"}],"standard_charges":[{"minimum":2260,"maximum":8362,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2373,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2599,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6237.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2260,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5424,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2260,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2305.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2305.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8362,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2305.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5537,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8362,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2327.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2327.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5582.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2327.8,"methodology":"case rate"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1142","type":"APR-DRG"}],"standard_charges":[{"minimum":2771,"maximum":10252.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2909.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3186.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":7647.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2771,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6650.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2771,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2826.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2826.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10252.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2826.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6788.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10252.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2854.13,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2854.13,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":6844.37,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2854.13,"methodology":"case rate"}]}]},{"description":"HC EXC H-F-NK-SP B9+MARG 0.5/<","code_information":[{"code":"11420","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1746.45,"maximum":3881,"gross_charge":3881,"discounted_cash":1358.35,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2716.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2522.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2522.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2716.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2522.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2716.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3881,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2910.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1940.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3298.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2134.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2134.55,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1746.45,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2134.55,"methodology":"fee schedule"}]}]},{"description":"HC EXC H-F-NK-SP B9+MARG 0.5/<","code_information":[{"code":"11420","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":78.05,"maximum":5274.3,"gross_charge":3881,"discounted_cash":1358.35,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2716.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2949.56,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":95.88,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":190.88,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":81.68,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":203.31,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":148.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":112.98,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2328.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2716.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2522.65,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2522.65,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2716.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2522.65,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":2328.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2716.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3881,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2910.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":2522.65,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":2522.65,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1746.45,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3298.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1824.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":81.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":89.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2134.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2134.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":120.2,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1404.15,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3206.49,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1591.21,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.05,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":104.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.05,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2134.55,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":79.61,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":79.61,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":243.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":79.61,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":106.93,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":243.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":78.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":104.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.05,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1047.87,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC H-F-NK-SP B9+MARG 0.6-1","code_information":[{"code":"11421","type":"CPT"}],"standard_charges":[{"minimum":91.17,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":112.64,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":224.25,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":95.96,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":238.85,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":174.18,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":136.96,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":95.73,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":104.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":140.4,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":91.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":122.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":91.17,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":92.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":92.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":284.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":92.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":124.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":284.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":91.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":91.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":122.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":91.17,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC EXC H-F-NK-SP B9+MARG 1.1-2","code_information":[{"code":"11422","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2191.05,"maximum":4869,"gross_charge":4869,"discounted_cash":1704.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3408.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3164.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3164.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3408.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3164.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3408.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4869,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3651.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4138.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2677.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2677.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2191.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2677.95,"methodology":"fee schedule"}]}]},{"description":"HC EXC H-F-NK-SP B9+MARG 1.1-2","code_information":[{"code":"11422","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":100.77,"maximum":5274.3,"gross_charge":4869,"discounted_cash":1704.15,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3408.3,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":3700.44,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":124.73,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":248.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":106.25,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":264.47,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":192.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":149.59,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2921.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3408.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3164.85,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3164.85,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3408.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3164.85,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":2921.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3408.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4869,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3651.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":3164.85,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":3164.85,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2191.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4138.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2288.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":105.81,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":115.89,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2677.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2677.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":155.19,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1761.61,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4022.77,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1996.29,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":100.77,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":135.03,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":100.77,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2677.95,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":102.79,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":102.79,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":314.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":102.79,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":138.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":314.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":100.77,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":100.77,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":135.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":100.77,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1314.63,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"HC EXC H-F-NK-SP B9+MARG 2.1-3","code_information":[{"code":"11423","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2529.45,"maximum":5621,"gross_charge":5621,"discounted_cash":1967.35,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3934.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3653.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3653.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3934.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3653.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3934.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5621,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4215.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2810.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4777.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3091.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3091.55,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2529.45,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3091.55,"methodology":"fee schedule"}]}]},{"description":"HC EXC H-F-NK-SP B9+MARG 2.1-3","code_information":[{"code":"11423","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":109.81,"maximum":5621,"gross_charge":5621,"discounted_cash":1967.35,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3934.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":4271.96,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":135.25,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":269.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":115.21,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":286.78,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":209.13,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":166.64,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3372.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3934.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3653.65,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3653.65,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3934.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3653.65,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":3372.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3934.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5621,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4215.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":3653.65,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":3653.65,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2529.45,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4777.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2641.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":126.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3091.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3091.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":169.11,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2033.68,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4644.08,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2304.61,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":109.81,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":147.15,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":109.81,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3091.55,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":112.01,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":112.01,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":342.61,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":112.01,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":150.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":342.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":109.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":109.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":147.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":109.81,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1517.67,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC H-F-NK-SP B9+MARG 3.1-4","code_information":[{"code":"11424","type":"CPT"}],"standard_charges":[{"minimum":511.75,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1152.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2800.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1262.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3019.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2292.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1837.8,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":588.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":788.1,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":701.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC H-F-NK-SP B9+MARG >4 CM","code_information":[{"code":"11426","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1143","type":"APR-DRG"}],"standard_charges":[{"minimum":4054,"maximum":14999.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4256.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4662.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11189.04,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4054,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9729.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4054,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4135.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4135.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14999.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4135.08,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9932.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14999.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4175.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4175.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10013.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4175.62,"methodology":"case rate"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1144","type":"APR-DRG"}],"standard_charges":[{"minimum":13348,"maximum":49387.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":14015.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15350.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":36840.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13348,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":32035.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13348,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":13614.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13614.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":49387.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13614.96,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":32702.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":49387.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13748.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":13748.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":32969.56,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13748.44,"methodology":"case rate"}]}]},{"description":"HC EXC FACE-MM B9+MARG 0.5CM/<","code_information":[{"code":"11440","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":447.75,"maximum":995,"gross_charge":995,"discounted_cash":348.25,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":696.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":646.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":646.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":696.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":646.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":696.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":995,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":746.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":497.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":845.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":547.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":547.25,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":447.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":547.25,"methodology":"fee schedule"}]}]},{"description":"HC EXC FACE-MM B9+MARG 0.5CM/<","code_information":[{"code":"11440","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":90.87,"maximum":5160,"gross_charge":995,"discounted_cash":348.25,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":696.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":756.2,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":109.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":218.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":93.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":232.23,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":169.35,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":129.4,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":597,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":696.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":646.75,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":646.75,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":696.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":646.75,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":597,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":696.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":995,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":746.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":646.75,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":646.75,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":447.75,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":845.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":467.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":95.41,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":104.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":547.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":547.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":139.94,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":360,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":822.07,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":407.95,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":121.77,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":547.25,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":92.69,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":92.69,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":283.51,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":92.69,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":124.49,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":283.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":121.77,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":90.87,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":268.65,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC FACE-MM B9+MARG 0.6-1 CM","code_information":[{"code":"11441","type":"CPT"}],"standard_charges":[{"minimum":101.06,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":123.16,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":245.19,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":104.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":261.15,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":190.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":149.59,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":106.11,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":116.22,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":155.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":101.06,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":135.42,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":101.06,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":103.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":103.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":315.31,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":103.08,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":138.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":315.31,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":101.06,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":101.06,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":135.42,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":101.06,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC FACE-MM B9+MARG 1.1-2 CM","code_information":[{"code":"11442","type":"CPT"}],"standard_charges":[{"minimum":109.22,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":133.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":265.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":113.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":282.65,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":206.13,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":164.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":114.68,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":125.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":168.2,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":109.22,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":146.35,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":109.22,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":111.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":111.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":340.77,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":111.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":149.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":340.77,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":109.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":109.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":146.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":109.22,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC FACE-MM B9+MARG 2.1-3 CM","code_information":[{"code":"11443","type":"CPT"}],"standard_charges":[{"minimum":120.29,"maximum":5274.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":147.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":294.08,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":125.84,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":313.23,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":228.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":182.4,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":126.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":138.33,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":185.25,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":120.29,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":161.19,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":120.29,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":122.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":122.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":375.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":122.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":164.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":375.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":120.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":120.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":161.19,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":120.29,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC FACE-MM B9+MARG 3.1-4 CM","code_information":[{"code":"11444","type":"CPT"}],"standard_charges":[{"minimum":511.75,"maximum":5274.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1152.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2800.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1262.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3019.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2292.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":954.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":958,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":588.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":788.1,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":701.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC FACE-MM B9+MARG >4 CM","code_information":[{"code":"11446","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11450","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11451","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11462","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11463","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11470","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11471","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"EXTRAOCULAR PROCEDURES EXCEPT ORBIT","code_information":[{"code":"115","type":"MS-DRG"}],"standard_charges":[{"minimum":9600.03,"maximum":43333.46,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":20533.39,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":17234,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":22847,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":36057,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":20734,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20000.06,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":20000.06,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":18666.72,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":20000.06,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":12401,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":18219,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":18219,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":19228,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":18000.05,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":43333.46,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":28290,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":28290,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":9600.03,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20000.06,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":11261,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":20600,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":15298,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":22885,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":22885,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":20000.06,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13600.04,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13333.37,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":13733.38,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":13333.37,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":13333.37,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":13466.71,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":14266.71,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13333.37,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13333.37,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":12900.04,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":16000.05,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":14266.71,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":14000.04,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":13600.04,"methodology":"case rate"}]}]},{"description":"OTHER EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1151","type":"APR-DRG"}],"standard_charges":[{"minimum":2236,"maximum":8273.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2347.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2571.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6171.36,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2236,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5366.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2236,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2280.72,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2280.72,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8273.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2280.72,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5478.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8273.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2303.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2303.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5522.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2303.08,"methodology":"case rate"}]}]},{"description":"OTHER EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1152","type":"APR-DRG"}],"standard_charges":[{"minimum":3997,"maximum":14788.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4196.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4596.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11031.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3997,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9592.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3997,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4076.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4076.94,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14788.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4076.94,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9792.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14788.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4116.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4116.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9872.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4116.91,"methodology":"case rate"}]}]},{"description":"OTHER EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1153","type":"APR-DRG"}],"standard_charges":[{"minimum":7793,"maximum":28834.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8182.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8961.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":21508.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7793,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":18703.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7793,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7948.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7948.86,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28834.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7948.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":19092.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":28834.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8026.79,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":8026.79,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":19248.71,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8026.79,"methodology":"case rate"}]}]},{"description":"OTHER EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1154","type":"APR-DRG"}],"standard_charges":[{"minimum":14326,"maximum":53006.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":15042.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16474.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":39539.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14326,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":34382.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14326,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":14612.52,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14612.52,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":53006.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14612.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":35098.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":53006.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14755.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":14755.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":35385.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14755.78,"methodology":"case rate"}]}]},{"description":"INTRAOCULAR PROCEDURES WITH CC/MCC","code_information":[{"code":"116","type":"MS-DRG"}],"standard_charges":[{"minimum":10369.29,"maximum":46805.79,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":22178.75,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":21402,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":24901,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":39297,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":22598,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21602.67,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":21602.67,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":20162.5,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":21602.67,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":13516,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":19856,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":19856,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":20956,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":19442.41,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":46805.79,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":30832,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":30832,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":10369.29,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21602.67,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":13178,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":22451,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":16673,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":24942,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":24942,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":21602.67,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":14689.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":14401.78,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":14833.84,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":14401.78,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":14401.78,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":14545.8,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":15409.91,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":14401.78,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":14401.78,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":13933.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":17282.14,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":15409.91,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":15121.87,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":14689.82,"methodology":"case rate"}]}]},{"description":"EXC TR-EXT MAL+MARG 0.5 CM/<","code_information":[{"code":"11600","type":"CPT"}],"standard_charges":[{"minimum":118.54,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.94,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":292.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":125.18,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":311.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":227.22,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":169.79,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":124.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":136.32,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":182.55,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":118.54,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":158.84,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":118.54,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":120.91,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":120.91,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":369.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":120.91,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":162.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":369.84,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":118.54,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":118.54,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":158.84,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":118.54,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC TR-EXT MAL+MARG 0.6-1 CM","code_information":[{"code":"11601","type":"CPT"}],"standard_charges":[{"minimum":130.76,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":163.71,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":325.9,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":139.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":347.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":253.14,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":205.77,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":137.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.37,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":201.37,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":130.76,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":175.22,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":130.76,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":133.38,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":133.38,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":407.97,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":133.38,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":179.14,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":407.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":130.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":130.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":175.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":130.76,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC EXC TR-EXT MAL+MARG 1.1-2 CM","code_information":[{"code":"11602","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":417.6,"maximum":928,"gross_charge":928,"discounted_cash":324.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":928,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":696,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":464,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":788.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":417.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":510.4,"methodology":"fee schedule"}]}]},{"description":"HC EXC TR-EXT MAL+MARG 1.1-2 CM","code_information":[{"code":"11602","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":138.04,"maximum":5160,"gross_charge":928,"discounted_cash":324.8,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":705.28,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":174.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":347.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":148.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":369.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":269.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":226.59,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":556.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":556.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":649.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":928,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":696,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":603.2,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":417.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":788.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":436.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":144.94,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":158.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":212.58,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":335.76,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":766.72,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":380.48,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":138.04,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":184.97,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":138.04,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":510.4,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":140.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":140.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":430.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":140.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":189.11,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":430.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":138.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":138.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":184.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":138.04,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":250.56,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"EXC TR-EXT MAL+MARG 2.1-3 CM","code_information":[{"code":"11603","type":"CPT"}],"standard_charges":[{"minimum":148.83,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":189.43,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":377.11,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":161.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":401.67,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":292.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":240.47,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":156.27,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":171.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":229.2,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":148.83,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":199.43,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":148.83,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":151.81,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":151.81,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":464.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":151.81,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":203.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":464.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":148.83,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":148.83,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":199.43,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":148.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC TR-EXT MAL+MARG 3.1-4 CM","code_information":[{"code":"11604","type":"CPT"}],"standard_charges":[{"minimum":271,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":512.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1244.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":561.21,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1342.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":1018.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":954.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":311.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":417.34,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":276.42,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":371.27,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":845.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":363.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":271,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC TR-EXT MAL+MARG >4 CM","code_information":[{"code":"11606","type":"CPT"}],"standard_charges":[{"minimum":511.75,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1152.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2800.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1262.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3019.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2292.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1837.8,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":588.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":788.1,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":701.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC H-F-NK-SP MAL+MARG 0.5/<","code_information":[{"code":"11620","type":"CPT"}],"standard_charges":[{"minimum":118.82,"maximum":5274.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":147.33,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":293.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":125.51,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":312.4,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":227.82,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":175.47,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":124.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":136.64,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":182.98,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":118.82,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":159.22,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":118.82,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":121.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":121.2,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":370.72,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":121.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":162.78,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":370.72,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":118.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":118.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":159.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":118.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG 0.6-1","code_information":[{"code":"11621","type":"CPT"}],"standard_charges":[{"minimum":131.06,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":164.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":326.67,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":139.78,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":347.94,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":253.74,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":208.29,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":137.61,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.72,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":201.83,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":131.06,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":175.62,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":131.06,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":133.68,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":133.68,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":408.91,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":133.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":179.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":408.91,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":131.06,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":131.06,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":175.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":131.06,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG 1.1-2","code_information":[{"code":"11622","type":"CPT"}],"standard_charges":[{"minimum":140.38,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":178.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":354.6,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":151.74,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":377.69,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":275.43,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":231.63,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":147.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":161.44,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":216.19,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":140.38,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":188.11,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":140.38,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":143.19,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":143.19,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":437.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":143.19,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":192.32,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":437.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":140.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":140.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":188.11,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":140.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG 2.1-3","code_information":[{"code":"11623","type":"CPT"}],"standard_charges":[{"minimum":140,"maximum":5274.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":195.66,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":389.52,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":166.68,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":414.88,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":302.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":249.31,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":161.78,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":177.19,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":237.28,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":154.08,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":206.47,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":154.08,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":157.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":157.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":480.73,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":157.16,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":211.09,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":480.73,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":154.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":154.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":206.47,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":154.08,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG 3.1-4","code_information":[{"code":"11624","type":"CPT"}],"standard_charges":[{"minimum":511.75,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1152.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2800.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1262.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3019.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2292.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1837.8,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":588.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":788.1,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":701.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG >4 CM","code_information":[{"code":"11626","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 0.5CM<","code_information":[{"code":"11640","type":"CPT"}],"standard_charges":[{"minimum":122.03,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":151.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":301.84,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":129.16,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":321.49,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":234.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":185.57,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":128.13,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":140.33,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":187.93,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":122.03,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":163.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":122.03,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":124.47,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":124.47,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":380.73,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":124.47,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":167.18,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":380.73,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":122.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":122.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":163.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":122.03,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 0.6-1","code_information":[{"code":"11641","type":"CPT"}],"standard_charges":[{"minimum":134.55,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":169.16,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":336.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":144.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":358.68,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":261.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":219.01,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":141.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":154.73,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":207.21,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":134.55,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":180.3,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":134.55,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":137.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":137.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":419.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":137.24,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":184.33,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":419.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":134.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":134.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":180.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":134.55,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 1.1-2","code_information":[{"code":"11642","type":"CPT"}],"standard_charges":[{"minimum":146.21,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":185.14,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":368.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":157.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":392.57,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":286.29,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":244.27,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.52,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":168.14,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":225.16,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":146.21,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":195.92,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":146.21,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":149.13,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":149.13,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":456.18,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":149.13,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":200.31,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":456.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":146.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":146.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":195.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":146.21,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 2.1-3","code_information":[{"code":"11643","type":"CPT"}],"standard_charges":[{"minimum":160.18,"maximum":5274.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":202.68,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":403.49,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":172.66,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":429.76,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":313.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":263.2,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":168.19,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":184.21,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":246.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":160.18,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":214.64,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":160.18,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":163.38,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":163.38,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":499.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":163.38,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":219.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":499.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":160.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":160.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":214.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":160.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 3.1-4","code_information":[{"code":"11644","type":"CPT"}],"standard_charges":[{"minimum":511.75,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2499.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1152.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":2800.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1262.79,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3019.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2292.24,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1837.8,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.97,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2272,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2190.86,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5274.3,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1168.46,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2434.29,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.34,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":588.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":788.1,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":521.99,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":701.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1596.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":685.75,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":511.75,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1655.32,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1671.55,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1639.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1622.86,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":1947.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1736.46,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1704,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1655.32,"methodology":"case rate"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG >4 CM","code_information":[{"code":"11646","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"INTRAOCULAR PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"117","type":"MS-DRG"}],"standard_charges":[{"minimum":7070.9,"maximum":31917.25,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":15123.87,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":11263,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":16096,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25402,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":14607,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14731.04,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":14731.04,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":13748.97,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":14731.04,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":8737,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":12835,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":12835,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":13546,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":13257.94,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":31917.25,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":19930,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":19930,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":7070.9,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14731.04,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8626,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":14513,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":10777,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":16123,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":16123,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":14731.04,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10017.11,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9820.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":10115.32,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":9820.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":9820.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":9918.9,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":10508.14,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9820.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9820.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":9501.52,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":11784.83,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":10508.14,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":10311.73,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":10017.11,"methodology":"case rate"}]}]},{"description":"HC TRIM NAILS ED","code_information":[{"code":"11719","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":44.1,"maximum":98,"gross_charge":98,"discounted_cash":34.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":63.7,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":63.7,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":63.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":98,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":73.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":49,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":83.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":53.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":53.9,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":44.1,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":53.9,"methodology":"fee schedule"}]}]},{"description":"HC TRIM NAILS ED","code_information":[{"code":"11719","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":10.78,"maximum":2700,"gross_charge":98,"discounted_cash":34.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":91.63,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":74.48,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":46.21,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":112.22,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":50.61,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":121.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":91.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":21.46,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":93.09,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":58.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":63.7,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":83.3,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":63.7,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":63.7,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":58.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":80.33,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":98,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":73.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":193.38,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":63.7,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":63.7,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":42.84,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":44.1,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":83.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":46.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.32,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10.78,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":53.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":53.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":14.45,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":35.46,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":80.97,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":40.18,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10.78,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":14.45,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10.78,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":53.9,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33.64,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":14.77,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33.64,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10.78,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":10.78,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":14.45,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10.78,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":60.69,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":61.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":60.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":63.66,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":71.4,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":26.46,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":63.66,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":62.48,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":60.69,"methodology":"case rate"}]}]},{"description":"HC DEBRIDE NAIL 1-5","code_information":[{"code":"11720","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":48.6,"maximum":108,"gross_charge":108,"discounted_cash":37.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":75.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":70.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":70.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":75.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":70.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":75.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":108,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":81,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":54,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":91.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":59.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":59.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":48.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":59.4,"methodology":"fee schedule"}]}]},{"description":"HC DEBRIDE NAIL 1-5","code_information":[{"code":"11720","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":26.51,"maximum":2700,"gross_charge":108,"discounted_cash":37.8,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":91.63,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":75.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":82.08,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":46.21,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":112.22,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":50.61,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":121.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":91.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":26.51,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":93.09,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":64.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":75.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":70.2,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":83.3,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":70.2,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":75.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":70.2,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":64.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":75.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":80.33,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":108,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":81,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":193.38,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":70.2,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":70.2,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":42.84,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":48.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":91.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":50.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":59.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":59.4,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":39.08,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":89.23,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":44.28,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":59.4,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":60.69,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":61.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":60.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":63.66,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":71.4,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":29.16,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":63.66,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":62.48,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":60.69,"methodology":"case rate"}]}]},{"description":"HC DEBRIDE NAIL 6 OR >","code_information":[{"code":"11721","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":74.7,"maximum":166,"gross_charge":166,"discounted_cash":58.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":166,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":83,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":141.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":91.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":91.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":74.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":91.3,"methodology":"fee schedule"}]}]},{"description":"HC DEBRIDE NAIL 6 OR >","code_information":[{"code":"11721","type":"CPT"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":32.18,"maximum":2700,"gross_charge":166,"discounted_cash":58.1,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":91.63,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":126.16,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":46.21,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":112.22,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":50.61,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":121.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":91.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":32.18,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":93.09,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":99.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":83.3,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":99.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":80.33,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":166,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":193.38,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":42.84,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":74.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":141.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":78.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":89.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":91.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":91.3,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":60.06,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":137.15,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":68.06,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":91.3,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":60.69,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":61.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":60.09,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":63.66,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":59.5,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":71.4,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":44.82,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":63.66,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":62.48,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":60.69,"methodology":"case rate"}]}]},{"description":"HC AVULSION OF SGL NAIL PLATE","code_information":[{"code":"11730","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":182.7,"maximum":406,"gross_charge":406,"discounted_cash":142.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":284.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":263.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":263.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":284.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":263.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":284.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":406,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":304.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":203,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":345.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":223.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":223.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":182.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":223.3,"methodology":"fee schedule"}]}]},{"description":"HC AVULSION OF SGL NAIL PLATE","code_information":[{"code":"11730","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":44.66,"maximum":2700,"gross_charge":406,"discounted_cash":142.1,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":284.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":308.56,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":243.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":284.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":263.9,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":263.9,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":284.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":263.9,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":243.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":284.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":406,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":304.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":263.9,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":263.9,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":182.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":345.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":190.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44.66,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":223.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":223.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":59.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":146.9,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":335.44,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":166.46,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44.66,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":59.85,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":44.66,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":223.3,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":45.56,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":45.56,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":139.34,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":45.56,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":61.19,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":139.34,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":44.66,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":44.66,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":59.85,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":44.66,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":109.62,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"REMOVE NAIL PLATE ADD-ON","code_information":[{"code":"11732","type":"CPT"}],"standard_charges":[{"minimum":32.18,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":32.18,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"HC EVAC SUBUNGUAL HEMATOMA","code_information":[{"code":"11740","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":112.5,"maximum":250,"gross_charge":250,"discounted_cash":87.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":175,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":162.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":162.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":175,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":162.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":175,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":250,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":187.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":125,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":212.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":137.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":137.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":112.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":137.5,"methodology":"fee schedule"}]}]},{"description":"HC EVAC SUBUNGUAL HEMATOMA","code_information":[{"code":"11740","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":27.5,"maximum":2700,"gross_charge":250,"discounted_cash":87.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":198.83,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":175,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":190,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":91.59,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":222.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":100.31,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":239.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":182.08,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":29.54,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":188.56,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":150,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":175,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":162.5,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":180.75,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":162.5,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":175,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":162.5,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":150,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":175,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":174.3,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":250,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":187.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":419.61,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":162.5,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":162.5,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":92.96,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":112.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":212.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":117.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":28.88,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":27.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":137.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":137.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":36.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":90.45,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":206.55,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":102.5,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":27.5,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":36.85,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":27.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":137.5,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":28.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":28.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":85.8,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":28.05,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":37.68,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":85.8,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":27.5,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":27.5,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":36.85,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":27.5,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":131.69,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":132.98,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":130.4,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":138.15,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":154.93,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":67.5,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":138.15,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":135.57,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":131.69,"methodology":"case rate"}]}]},{"description":"HC REMOVAL OF NAIL BED","code_information":[{"code":"11750","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":486.9,"maximum":1082,"gross_charge":1082,"discounted_cash":378.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":757.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":703.3,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":703.3,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":757.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":703.3,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":757.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1082,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":811.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":541,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":919.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":595.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":595.1,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":486.9,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":595.1,"methodology":"fee schedule"}]}]},{"description":"HC REMOVAL OF NAIL BED","code_information":[{"code":"11750","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":89.11,"maximum":5160,"gross_charge":1082,"discounted_cash":378.7,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":757.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":822.32,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":107.19,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":213.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":91.31,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":227.28,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":165.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":170.42,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":649.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":757.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":703.3,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":703.3,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":757.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":703.3,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":649.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":757.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1082,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":811.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":703.3,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":703.3,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":486.9,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":919.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":508.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.57,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":102.48,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":595.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":595.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":137.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":391.47,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":893.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":443.62,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":89.11,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":119.41,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":89.11,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":595.1,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":90.89,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":90.89,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":278.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":90.89,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":122.08,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":278.02,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":89.11,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":89.11,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":119.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":89.11,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":292.14,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"BIOPSY NAIL UNIT","code_information":[{"code":"11755","type":"CPT"}],"standard_charges":[{"minimum":67.57,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":83.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":165.27,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":70.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":176.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":128.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":118.02,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":70.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":77.71,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":104.06,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":90.54,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":68.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":68.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":210.82,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":68.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":92.57,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":210.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":90.54,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":67.57,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"HC REPAIR NAIL BED","code_information":[{"code":"11760","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":282.6,"maximum":628,"gross_charge":628,"discounted_cash":219.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":628,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":471,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":314,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":533.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":282.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":345.4,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR NAIL BED","code_information":[{"code":"11760","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":110.67,"maximum":2700,"gross_charge":628,"discounted_cash":219.8,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":477.28,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":376.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":376.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":439.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":628,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":471,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":408.2,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":282.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":533.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":295.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":116.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":127.27,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":170.43,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":227.22,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":518.86,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":257.48,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":148.3,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":112.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":112.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":345.29,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":112.88,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":151.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":345.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":148.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":110.67,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":169.56,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"RECONSTRUCTION OF NAIL BED","code_information":[{"code":"11762","type":"CPT"}],"standard_charges":[{"minimum":140,"maximum":5954.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":201.9,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":401.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":171.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":428.09,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":312.19,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":217.12,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.51,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":180.18,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":241.29,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":156.68,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":209.95,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":156.68,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":159.81,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":159.81,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":488.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":159.81,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":214.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":488.84,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":156.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":156.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":209.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":156.68,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"HC WEDGE EXC NAIL FOLD","code_information":[{"code":"11765","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":379.8,"maximum":844,"gross_charge":844,"discounted_cash":295.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":548.6,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":548.6,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":548.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":844,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":633,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":422,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":717.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":464.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":464.2,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":379.8,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":464.2,"methodology":"fee schedule"}]}]},{"description":"HC WEDGE EXC NAIL FOLD","code_information":[{"code":"11765","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"gross_charge":844,"discounted_cash":295.4,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":641.44,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":506.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":548.6,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":548.6,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":548.6,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":506.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":844,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":633,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":548.6,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":548.6,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":379.8,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":717.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":396.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":97.49,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":92.84,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":464.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":464.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":124.41,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":305.36,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":697.32,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":346.04,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":92.84,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":124.41,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":92.84,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":464.2,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":94.7,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":94.7,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":289.67,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":94.7,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":127.2,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":289.67,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":92.84,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":92.84,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":124.41,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":92.84,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":227.88,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"REMOVE PILONIDAL CYST SIMPLE","code_information":[{"code":"11770","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"REMOVE PILONIDAL CYST EXTEN","code_information":[{"code":"11771","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"REMOVE PILONIDAL CYST COMPL","code_information":[{"code":"11772","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"HC INJECT SKIN LESIONS </W 7","code_information":[{"code":"11900","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":202.05,"maximum":449,"gross_charge":449,"discounted_cash":157.15,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":314.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":291.85,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":291.85,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":314.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":291.85,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":314.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":449,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":336.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":224.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":381.65,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":246.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":246.95,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":202.05,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":246.95,"methodology":"fee schedule"}]}]},{"description":"HC INJECT SKIN LESIONS </W 7","code_information":[{"code":"11900","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":53.66,"maximum":2700,"gross_charge":449,"discounted_cash":157.15,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":314.3,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":341.24,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":53.66,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":269.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":314.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":291.85,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":291.85,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":314.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":291.85,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":269.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":314.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":449,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":336.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":291.85,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":291.85,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":202.05,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":381.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":211.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":246.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":246.95,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":162.45,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":370.97,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":184.09,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":246.95,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":121.23,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"INJECT SKIN LESIONS >7","code_information":[{"code":"11901","type":"CPT"}],"standard_charges":[{"minimum":58.49,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":58.49,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"CORRECT SKIN COLOR 6.0 CM/<","code_information":[{"code":"11920","type":"CPT"}],"standard_charges":[{"minimum":114.17,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":134.08,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":266.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":114.22,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":284.3,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":207.33,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":169.79,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":119.88,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":131.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":175.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":114.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":152.99,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":114.17,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":116.45,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":116.45,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":356.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":116.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":156.41,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":356.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":114.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":114.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":152.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":114.17,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"CORRECT SKN COLOR 6.1-20.0CM","code_information":[{"code":"11921","type":"CPT"}],"standard_charges":[{"minimum":126.1,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":148.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":295.63,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":126.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":314.88,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":229.63,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":186.83,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":132.41,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":145.01,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":194.19,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":126.1,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":168.97,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":126.1,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":128.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":128.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":393.43,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":128.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":172.76,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":393.43,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":126.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":126.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":168.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":126.1,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"CORRECT SKIN COLOR EA 20.0CM","code_information":[{"code":"11922","type":"CPT"}],"standard_charges":[{"minimum":60.59,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":60.59,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"TX CONTOUR DEFECTS 1 CC/<","code_information":[{"code":"11950","type":"CPT"}],"standard_charges":[{"minimum":40.48,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":50.28,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":100.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":42.84,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":106.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":77.76,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":61.86,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":42.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":46.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":62.34,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":40.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":54.24,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":40.48,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":41.29,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":41.29,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":126.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":41.29,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":55.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":126.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":40.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":40.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":54.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":40.48,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"TX CONTOUR DEFECTS 1.1-5.0CC","code_information":[{"code":"11951","type":"CPT"}],"standard_charges":[{"minimum":51.55,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":64.7,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":128.81,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":55.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":137.19,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":100.05,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":77,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":54.13,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":59.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":79.39,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":51.55,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":69.08,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":51.55,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":52.58,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":52.58,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":160.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":52.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":70.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":160.84,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":51.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":51.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":69.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":51.55,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"TX CONTOUR DEFECTS 5.1-10CC","code_information":[{"code":"11952","type":"CPT"}],"standard_charges":[{"minimum":65.53,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":83.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":166.04,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":71.05,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":176.86,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":128.97,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.81,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":75.36,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":100.92,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":65.53,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":87.81,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":65.53,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":66.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":66.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":204.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":66.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":89.78,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":204.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":65.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":65.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":87.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":65.53,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"TX CONTOUR DEFECTS >10.0 CC","code_information":[{"code":"11954","type":"CPT"}],"standard_charges":[{"minimum":72.52,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":92.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":183.89,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":78.69,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":195.86,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":142.84,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":83.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":111.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":72.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":97.18,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":72.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":73.97,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":73.97,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":226.26,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":73.97,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":99.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":226.26,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":72.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":72.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":97.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":72.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"INSERT TISSUE EXPANDER(S)","code_information":[{"code":"11960","type":"CPT"}],"standard_charges":[{"minimum":1195,"maximum":11917.42,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":5647.03,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":2500.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":6073.67,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2739.11,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":6550.04,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":4972.07,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2435.25,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5888.55,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5500.35,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":5500.35,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":5133.66,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":5500.35,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":4950.31,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":11917.42,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2640.17,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5500.35,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4680,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":5500.35,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":1610.09,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1763.43,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":2361.47,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1533.42,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":2054.78,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1533.42,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1564.09,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1564.09,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4784.27,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1564.09,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":2100.79,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4784.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1533.42,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":1533.42,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":2054.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1533.42,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":3740.24,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":3666.9,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":3776.91,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":3666.9,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":3666.9,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":3703.57,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3923.58,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":3666.9,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":3666.9,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":3666.9,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":4400.28,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3923.58,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3850.24,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":3740.24,"methodology":"case rate"}]}]},{"description":"REPLACE TISSUE EXPANDER","code_information":[{"code":"11970","type":"CPT"}],"standard_charges":[{"minimum":1369,"maximum":23254.72,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":11019.16,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":5024.84,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":12203.18,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":5503.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":13160.29,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":9989.86,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":5243,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":10474.69,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10732.95,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":10732.95,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":10017.42,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":10732.95,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":9659.66,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":23254.72,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5151.82,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10732.95,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4343,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3224,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":4823,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":4823,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":10732.95,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3434.19,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3761.26,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":5036.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3270.66,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":4382.68,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3270.66,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3336.07,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3336.07,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10204.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3336.07,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":4480.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10204.46,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3270.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3270.66,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":4382.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3270.66,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7298.41,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7155.3,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":7369.96,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":7155.3,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":7155.3,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":7226.85,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":7656.17,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7155.3,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7155.3,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":7155.3,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":8586.36,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":7656.17,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":7513.06,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":7298.41,"methodology":"case rate"}]}]},{"description":"REMOVE TISSUE EXPANDER(S)","code_information":[{"code":"11971","type":"CPT"}],"standard_charges":[{"minimum":857.59,"maximum":9316.74,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":4414.7,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1947.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":4730.54,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":2133.38,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":5101.56,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":3872.55,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2525.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3965.11,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":4013.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":958,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":3870.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":9316.74,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":2064.02,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":4896,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":3636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":5439,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":4300.03,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":900.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":986.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1320.69,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":874.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1174.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2675.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":1149.17,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":857.59,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2924.02,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":2952.69,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":2895.36,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":2866.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":3440.03,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":3067.36,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":3010.02,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":2924.02,"methodology":"case rate"}]}]},{"description":"REMOVE CONTRACEPTIVE CAPSULE","code_information":[{"code":"11976","type":"CPT"}],"standard_charges":[{"minimum":64.95,"maximum":5160,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":1085.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":81.46,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":162.17,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":69.4,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":172.73,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":125.97,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":112.98,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.66,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":986.62,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":951.39,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":2290.37,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":507.41,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":1057.1,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":74.69,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":100.02,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":64.95,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":87.03,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":64.95,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":66.25,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":66.25,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":202.64,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":66.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":88.98,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":202.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":64.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":64.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":87.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":64.95,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":718.82,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":725.87,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":711.78,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":704.73,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":845.68,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":754.06,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":739.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":718.82,"methodology":"case rate"}]}]},{"description":"IMPLANT HORMONE PELLET(S)","code_information":[{"code":"11980","type":"CPT"}],"standard_charges":[{"minimum":45.64,"maximum":2700,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":615.52,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":305.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":741.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":334.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":799.9,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":607.2,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":45.64,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":453.87,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":559.57,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":539.58,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1298.99,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":287.78,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":407.68,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":411.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":403.69,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":427.67,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":479.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":427.67,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":419.67,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":407.68,"methodology":"case rate"}]}]},{"description":"HC INSERTION DRUG DLVR IMPLANT","code_information":[{"code":"11981","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":135.45,"maximum":301,"gross_charge":301,"discounted_cash":105.35,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":210.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":195.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":195.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":210.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":195.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":210.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":301,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":225.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":150.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":255.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":165.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":165.55,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":135.45,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":165.55,"methodology":"fee schedule"}]}]},{"description":"HC INSERTION DRUG DLVR IMPLANT","code_information":[{"code":"11981","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":45.64,"maximum":2700,"gross_charge":301,"discounted_cash":105.35,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":198.83,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":210.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":228.76,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":91.59,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":222.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":100.31,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":239.87,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":182.08,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":45.64,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":188.56,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":180.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":210.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":195.65,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":180.75,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":195.65,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":210.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":195.65,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":180.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":210.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":174.3,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":301,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":225.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":419.61,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":195.65,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":195.65,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":92.96,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":135.45,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":255.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":141.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":193.67,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.23,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":56.11,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":165.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":165.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":75.14,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":108.91,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":248.69,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":123.41,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":48.79,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":65.38,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":48.79,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":165.55,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":49.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":49.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":152.22,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":49.77,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":66.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":152.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":48.79,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":48.79,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":65.38,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":48.79,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":131.69,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":132.98,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":130.4,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":138.15,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":129.11,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":154.93,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":81.27,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":138.15,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":135.57,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":131.69,"methodology":"case rate"}]}]},{"description":"HC REMOVE DRUG IMPLANT DEVICE","code_information":[{"code":"11982","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":440.1,"maximum":978,"gross_charge":978,"discounted_cash":342.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":684.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":635.7,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":635.7,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":684.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":635.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":684.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":978,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":733.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":489,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":831.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":537.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":537.9,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":440.1,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":537.9,"methodology":"fee schedule"}]}]},{"description":"HC REMOVE DRUG IMPLANT DEVICE","code_information":[{"code":"11982","type":"CPT"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":45.64,"maximum":2700,"gross_charge":978,"discounted_cash":342.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":615.52,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":684.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":743.28,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":305.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":741.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":334.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":799.9,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":607.2,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":45.64,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":453.87,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":586.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":684.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":635.7,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":559.57,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":635.7,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":684.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":635.7,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":586.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":684.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":539.58,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":978,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":733.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1298.99,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":635.7,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":635.7,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":287.78,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":440.1,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":831.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":459.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":60.11,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":65.84,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":537.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":537.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":88.17,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":353.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":808.03,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":400.98,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":57.25,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":76.72,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":57.25,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":537.9,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":58.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":58.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":178.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":58.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":78.43,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":178.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":57.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":57.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":76.72,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":57.25,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":407.68,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":411.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":403.69,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":427.67,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":479.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":264.06,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":427.67,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":419.67,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":407.68,"methodology":"case rate"}]}]},{"description":"HC REMOVE/INSERT DRUG IMPLANT","code_information":[{"code":"11983","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":423,"maximum":940,"gross_charge":940,"discounted_cash":329,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":658,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":611,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":611,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":658,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":611,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":658,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":940,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":705,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":470,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":799,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":517,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":517,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":423,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":517,"methodology":"fee schedule"}]}]},{"description":"HC REMOVE/INSERT DRUG IMPLANT","code_information":[{"code":"11983","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":45.64,"maximum":2700,"gross_charge":940,"discounted_cash":329,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":615.52,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":658,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":714.4,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":305.42,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":741.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":334.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":799.9,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":607.2,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":45.64,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":453.87,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":564,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":658,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":611,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":559.57,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":611,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":658,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":611,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":564,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":658,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.8,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":539.58,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":940,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":705,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1298.99,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":611,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":611,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":287.78,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":423,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":799,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":441.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":599.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":83.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":91.94,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":517,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":517,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":123.12,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":340.1,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":776.63,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":385.4,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":79.95,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":107.13,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":79.95,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":517,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":81.55,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":81.55,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":249.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":81.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":109.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":249.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":79.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":79.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":107.13,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":79.95,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":407.68,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":411.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":403.69,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":427.67,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":399.69,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":479.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":253.8,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":427.67,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":419.67,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":407.68,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIMSCLP 2.5CM/<","code_information":[{"code":"12001","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":465.75,"maximum":1035,"gross_charge":1035,"discounted_cash":362.25,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":724.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":672.75,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":672.75,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":724.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":672.75,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":724.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1035,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":776.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":517.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":879.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":569.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":569.25,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":465.75,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":569.25,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIMSCLP 2.5CM/<","code_information":[{"code":"12001","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":2700,"gross_charge":1035,"discounted_cash":362.25,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":724.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":786.6,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":621,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":724.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":672.75,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":672.75,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":724.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":672.75,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":621,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":724.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1035,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":776.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":672.75,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":672.75,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":465.75,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":879.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":486.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":119.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":113.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":569.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":569.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":152.56,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":374.47,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":855.12,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":424.35,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":113.85,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":152.56,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":113.85,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":569.25,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":116.13,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":116.13,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":355.22,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":116.13,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":155.98,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":355.22,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":113.85,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":113.85,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":152.56,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":113.85,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":279.45,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM SCLP 2.6-7.5CM","code_information":[{"code":"12002","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":610.2,"maximum":1356,"gross_charge":1356,"discounted_cash":474.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":949.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":881.4,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":881.4,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":949.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":881.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":949.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1356,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1017,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":678,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1152.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":745.8,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":610.2,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.8,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM SCLP 2.6-7.5CM","code_information":[{"code":"12002","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":2700,"gross_charge":1356,"discounted_cash":474.6,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":949.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1030.56,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":813.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":949.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":881.4,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":881.4,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":949.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":881.4,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":813.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":949.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1356,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1017,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":881.4,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":881.4,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":610.2,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1152.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":637.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":156.62,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":149.16,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":745.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":199.88,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":490.61,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1120.33,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":555.96,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":149.16,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":199.88,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":149.16,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.8,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":152.15,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":152.15,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":465.38,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":152.15,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":204.35,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":465.38,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":149.16,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":149.16,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":199.88,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":149.16,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":366.12,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM SCLP 7.6-12.5CM","code_information":[{"code":"12004","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":764.1,"maximum":1698,"gross_charge":1698,"discounted_cash":594.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1188.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1103.7,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1103.7,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1188.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1103.7,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1188.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1698,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1273.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":849,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":933.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":933.9,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":764.1,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":933.9,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM SCLP 7.6-12.5CM","code_information":[{"code":"12004","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":2700,"gross_charge":1698,"discounted_cash":594.3,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1188.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1290.48,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1018.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1188.6,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1103.7,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1103.7,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1188.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1103.7,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1018.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1188.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1698,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1273.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":1103.7,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":1103.7,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":764.1,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":798.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":196.12,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":186.78,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":933.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":933.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":250.29,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":614.34,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1402.89,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":696.18,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":186.78,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":250.29,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":186.78,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":933.9,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":190.52,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":190.52,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":582.76,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":190.52,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":255.89,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":582.76,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":186.78,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":186.78,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":250.29,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":186.78,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":458.46,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM SCLP 12.6-20CM","code_information":[{"code":"12005","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":978.3,"maximum":2174,"gross_charge":2174,"discounted_cash":760.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1521.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1413.1,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1413.1,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1521.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1413.1,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1521.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2174,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1630.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1087,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1847.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1195.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1195.7,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":978.3,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1195.7,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM SCLP 12.6-20CM","code_information":[{"code":"12005","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"gross_charge":2174,"discounted_cash":760.9,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1521.8,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1652.24,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1304.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1521.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1413.1,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1413.1,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1521.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1413.1,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1521.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2174,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1630.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":978.3,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1847.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1021.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1195.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1195.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":786.56,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1796.16,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":891.34,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1195.7,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":586.98,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM SCLP 20.1-30CM","code_information":[{"code":"12006","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1197,"maximum":2660,"gross_charge":2660,"discounted_cash":931,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1862,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1729,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1729,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1862,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1729,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1862,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2660,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1995,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1330,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2261,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1463,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1463,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1197,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1463,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM SCLP 20.1-30CM","code_information":[{"code":"12006","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"gross_charge":2660,"discounted_cash":931,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1862,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2021.6,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1596,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1862,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1729,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1729,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1862,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1729,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1862,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2660,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1995,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1197,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2261,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1250.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1463,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1463,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":962.39,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2197.7,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1090.6,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1463,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":718.2,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM SCLP>30CM","code_information":[{"code":"12007","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1490.4,"maximum":3312,"gross_charge":3312,"discounted_cash":1159.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2318.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2152.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2152.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2318.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2152.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2318.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3312,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2484,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1656,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2815.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1821.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1821.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1490.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1821.6,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM SCLP>30CM","code_information":[{"code":"12007","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":78.21,"maximum":7221,"gross_charge":3312,"discounted_cash":1159.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2318.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2517.12,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1987.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2318.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2152.8,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2152.8,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2318.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2152.8,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2318.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3312,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2484,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1490.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2815.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1556.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.12,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":89.94,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1821.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1821.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":120.44,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1198.29,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2736.38,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1357.92,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1821.6,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":107.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":894.24,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1201","type":"APR-DRG"}],"standard_charges":[{"minimum":8974,"maximum":33203.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9422.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10320.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":24768.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8974,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":21537.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8974,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9153.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9153.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33203.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9153.48,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":21986.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33203.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9243.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9243.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":22165.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9243.22,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM FACE 2.5CM/<","code_information":[{"code":"12011","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":502.2,"maximum":1116,"gross_charge":1116,"discounted_cash":390.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":781.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":725.4,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":725.4,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":781.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":725.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":781.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1116,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":837,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":558,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":948.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":613.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":613.8,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":502.2,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":613.8,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM FACE 2.5CM/<","code_information":[{"code":"12011","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":2700,"gross_charge":1116,"discounted_cash":390.6,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":781.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":848.16,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":669.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":781.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":725.4,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":725.4,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":781.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":725.4,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":669.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":781.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1116,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":837,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":725.4,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":725.4,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":502.2,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":948.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":524.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":128.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":122.76,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":613.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":613.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":164.5,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":403.77,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":922.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":457.56,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":122.76,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":164.5,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":122.76,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":613.8,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":125.22,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":125.22,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":383.02,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":125.22,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":168.19,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":383.02,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":122.76,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":122.76,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":164.5,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":122.76,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":301.32,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM FACE 2.6-5CM","code_information":[{"code":"12013","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":522.45,"maximum":1161,"gross_charge":1161,"discounted_cash":406.35,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":812.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":812.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":812.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1161,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":870.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":580.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":986.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":638.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":638.55,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":522.45,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":638.55,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM FACE 2.6-5CM","code_information":[{"code":"12013","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":2700,"gross_charge":1161,"discounted_cash":406.35,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":812.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":882.36,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":696.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":812.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":812.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":696.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":812.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1161,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":870.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":754.65,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":522.45,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":986.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":545.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":127.71,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":638.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":638.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":171.14,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":420.05,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":959.22,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":476.01,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":127.71,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":171.14,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":127.71,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":638.55,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":130.27,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":130.27,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":398.46,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":130.27,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":174.97,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":398.46,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":127.71,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":127.71,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":171.14,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":127.71,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":313.47,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM FACE 5.1-7.5CM","code_information":[{"code":"12014","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":673.2,"maximum":1496,"gross_charge":1496,"discounted_cash":523.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1047.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":972.4,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":972.4,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1047.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":972.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1047.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1496,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1122,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":748,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1271.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":822.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":822.8,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":673.2,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":822.8,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM FACE 5.1-7.5CM","code_information":[{"code":"12014","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":2700,"gross_charge":1496,"discounted_cash":523.6,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1047.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1136.96,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":897.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1047.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":972.4,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":972.4,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1047.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":972.4,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":897.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1047.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1496,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1122,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":972.4,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":972.4,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":673.2,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1271.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":703.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":172.79,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":164.56,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":822.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":822.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":220.52,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":541.26,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1236,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":613.36,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":164.56,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":220.52,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":164.56,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":822.8,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":167.86,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":167.86,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":513.43,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":167.86,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":225.45,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":513.43,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":164.56,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":164.56,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":220.52,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":164.56,"methodology":"fee schedule"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":403.92,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM FACE 7.6-12.5CM","code_information":[{"code":"12015","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":849.15,"maximum":1887,"gross_charge":1887,"discounted_cash":660.45,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1320.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1226.55,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1226.55,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1320.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1226.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1320.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1887,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1415.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":943.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1603.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1037.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1037.85,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":849.15,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1037.85,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM FACE 7.6-12.5CM","code_information":[{"code":"12015","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":78.21,"maximum":2700,"gross_charge":1887,"discounted_cash":660.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1320.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1434.12,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1132.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1320.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1226.55,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1226.55,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1320.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1226.55,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1132.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1320.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1887,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1415.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":1226.55,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":1226.55,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":849.15,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1603.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":886.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.12,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":89.94,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1037.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1037.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":120.44,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":682.72,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1559.04,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":773.67,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1037.85,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":107.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":509.49,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM FACE 12.6-20CM","code_information":[{"code":"12016","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1150.2,"maximum":2556,"gross_charge":2556,"discounted_cash":894.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1789.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1661.4,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1661.4,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1789.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1661.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1789.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2556,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1917,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1278,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2172.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1405.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1405.8,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1150.2,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1405.8,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM FACE 12.6-20CM","code_information":[{"code":"12016","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"gross_charge":2556,"discounted_cash":894.6,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1789.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1942.56,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1533.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1789.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1661.4,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1661.4,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1789.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1661.4,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1789.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2556,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1917,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1150.2,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2172.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1201.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1405.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1405.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":924.77,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2111.77,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1047.96,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1405.8,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":690.12,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"RPR FE/E/EN/L/M 20.1-30.0 CM","code_information":[{"code":"12017","type":"CPT"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"RPR F/E/E/N/L/M >30.0 CM","code_information":[{"code":"12018","type":"CPT"}],"standard_charges":[{"minimum":78.21,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":306.49,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":146.77,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":356.45,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":160.75,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":384.41,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":291.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":300.3,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":278.63,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":268.68,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":646.82,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":143.29,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":298.53,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.12,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":89.94,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":120.44,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":79.77,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":107.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":244.02,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":104.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":78.21,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":203,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":204.99,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":201.01,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":199.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":238.82,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":212.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":208.97,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":203,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1202","type":"APR-DRG"}],"standard_charges":[{"minimum":9180,"maximum":33966,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9639,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10557,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":25336.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9180,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":22032,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9180,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9363.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9363.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33966,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9363.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":22491,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":33966,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9455.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9455.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":22674.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9455.4,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM WND DEHISC","code_information":[{"code":"12020","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":302.4,"maximum":672,"gross_charge":672,"discounted_cash":235.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":470.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":470.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":470.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":672,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":504,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":336,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":571.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":369.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":369.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":302.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":369.6,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM WND DEHISC","code_information":[{"code":"12020","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":181.44,"maximum":5160,"gross_charge":672,"discounted_cash":235.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":470.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":510.72,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":512.19,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":403.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":470.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":958,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":470.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":470.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":672,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":504,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":302.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":571.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":315.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":369.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":369.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":243.13,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":555.21,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":275.52,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":369.6,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":181.44,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC REPAIR SIM WND DEHIS W PACK","code_information":[{"code":"12021","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":200.25,"maximum":445,"gross_charge":445,"discounted_cash":155.75,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":445,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":333.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":222.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":378.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":200.25,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":244.75,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR SIM WND DEHIS W PACK","code_information":[{"code":"12021","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":120.15,"maximum":5160,"gross_charge":445,"discounted_cash":155.75,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":338.2,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":267,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2054,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5160,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":1864,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":958,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":289.25,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":445,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":333.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":200.25,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":378.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":209.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":161.01,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":367.66,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":182.45,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":120.15,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1203","type":"APR-DRG"}],"standard_charges":[{"minimum":12944,"maximum":47892.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":13591.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14885.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":35725.44,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12944,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":31065.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12944,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":13202.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13202.88,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":47892.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13202.88,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":31712.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":47892.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13332.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":13332.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":31971.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":13332.32,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT SCLP 2.5CM /<","code_information":[{"code":"12031","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1910.25,"maximum":4245,"gross_charge":4245,"discounted_cash":1485.75,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2971.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2759.25,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2759.25,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2971.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2759.25,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2971.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4245,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3183.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2122.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3608.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2334.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2334.75,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1910.25,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2334.75,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT SCLP 2.5CM /<","code_information":[{"code":"12031","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":4245,"gross_charge":4245,"discounted_cash":1485.75,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2971.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":3226.2,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":174.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":347.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":148.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":369.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":269.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2547,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2971.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2759.25,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2759.25,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2971.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2759.25,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":2547,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2971.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":4245,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3183.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":2759.25,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":2759.25,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1910.25,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3608.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1995.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2334.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2334.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1535.85,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3507.22,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1740.45,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2334.75,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1146.15,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT SCLP 2.6-7.5CM","code_information":[{"code":"12032","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":2387.7,"maximum":5306,"gross_charge":5306,"discounted_cash":1857.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3714.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3448.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3448.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3714.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3448.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3714.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5306,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3979.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2653,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4510.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2918.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2918.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2387.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2918.3,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT SCLP 2.6-7.5CM","code_information":[{"code":"12032","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":140,"maximum":5306,"gross_charge":5306,"discounted_cash":1857.1,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3714.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":4032.56,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":174.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":347.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":148.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":369.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":269.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":243.08,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3183.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3714.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3448.9,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3448.9,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3714.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3448.9,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":3183.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3714.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5306,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3979.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":3448.9,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":3448.9,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2387.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4510.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2493.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2918.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2918.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1919.72,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4383.82,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2175.46,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2918.3,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1432.62,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT SCLP 7.6-12.5CM","code_information":[{"code":"12034","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":2578.95,"maximum":5731,"gross_charge":5731,"discounted_cash":2005.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4011.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3725.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3725.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4011.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3725.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4011.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5731,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4298.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2865.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4871.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3152.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3152.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2578.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3152.05,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT SCLP 7.6-12.5CM","code_information":[{"code":"12034","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"gross_charge":5731,"discounted_cash":2005.85,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4011.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":4355.56,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3438.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4011.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3725.15,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3725.15,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4011.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3725.15,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4011.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5731,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":4298.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2578.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4871.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2693.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3152.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3152.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2073.48,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4734.96,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2349.71,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3152.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1547.37,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT SCLP 12.6-20CM","code_information":[{"code":"12035","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":3008.7,"maximum":6686,"gross_charge":6686,"discounted_cash":2340.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4680.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4345.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4345.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4680.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4345.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4680.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":6686,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5014.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3343,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":5683.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3677.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3677.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3008.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3677.3,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT SCLP 12.6-20CM","code_information":[{"code":"12035","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"gross_charge":6686,"discounted_cash":2340.1,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4680.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":5081.36,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":4011.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":4680.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":4345.9,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":4345.9,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":4680.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":4345.9,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":4680.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":6686,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5014.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3008.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":5683.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3142.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3677.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":3677.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2419,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5523.98,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2741.26,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":3677.3,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1805.22,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT SCLP 20.1-30CM","code_information":[{"code":"12036","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":3510,"maximum":7800,"gross_charge":7800,"discounted_cash":2730,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5460,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5070,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5070,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5460,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5070,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5460,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7800,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5850,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":3900,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6630,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4290,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4290,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3510,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4290,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT SCLP 20.1-30CM","code_information":[{"code":"12036","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":228.07,"maximum":7800,"gross_charge":7800,"discounted_cash":2730,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5460,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":5928,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":4680,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":5460,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5070,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5070,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":5460,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5070,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":5460,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":7800,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":5850,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":3510,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":6630,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":3666,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4290,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4290,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":2822.04,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6444.36,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3198,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4290,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2106,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT WND S/TR/EXT 30.0+CM","code_information":[{"code":"12037","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":4083.3,"maximum":9074,"gross_charge":9074,"discounted_cash":3175.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6351.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5898.1,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5898.1,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6351.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5898.1,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6351.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9074,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6805.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":4537,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7712.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4990.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4990.7,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":4083.3,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4990.7,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT WND S/TR/EXT 30.0+CM","code_information":[{"code":"12037","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":397.85,"maximum":9074,"gross_charge":9074,"discounted_cash":3175.9,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":6351.8,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":6896.24,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":5444.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":6351.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":5898.1,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":5898.1,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":6351.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":5898.1,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":6351.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":9074,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":6805.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":4083.3,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":7712.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":4264.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4990.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":4990.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":3282.98,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":7496.94,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":3720.34,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":4990.7,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":2449.98,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1204","type":"APR-DRG"}],"standard_charges":[{"minimum":38175,"maximum":141247.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":40083.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":43901.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":105363,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38175,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":91620,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":38175,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":38938.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":38938.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":141247.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38938.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":93528.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":141247.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":39320.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":39320.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":94292.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":39320.25,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT N-HF/GN <2.5CM/<","code_information":[{"code":"12041","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":172.8,"maximum":384,"gross_charge":384,"discounted_cash":134.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":384,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":288,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":192,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":172.8,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":211.2,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT N-HF/GN <2.5CM/<","code_information":[{"code":"12041","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":2700,"gross_charge":384,"discounted_cash":134.4,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":291.84,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":174.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":347.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":148.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":369.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":269.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":230.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":230.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":384,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":288,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":172.8,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":180.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":138.94,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":317.27,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":157.44,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":103.68,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT N-HF/GN2.6-7.5CM","code_information":[{"code":"12042","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":239.4,"maximum":532,"gross_charge":532,"discounted_cash":186.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":372.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":345.8,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":345.8,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":372.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":345.8,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":372.4,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":532,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":399,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":266,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":452.2,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":239.4,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":292.6,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT N-HF/GN2.6-7.5CM","code_information":[{"code":"12042","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":2700,"gross_charge":532,"discounted_cash":186.2,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":372.4,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":404.32,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":174.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":347.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":148.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":369.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":269.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":319.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":372.4,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":345.8,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":345.8,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":372.4,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":345.8,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":319.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":372.4,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":532,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":399,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":345.8,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":345.8,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":239.4,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":452.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":250.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":192.48,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":439.54,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":218.12,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":143.64,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT N-HF/GN7.6-12.5CM","code_information":[{"code":"12044","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":632.25,"maximum":1405,"gross_charge":1405,"discounted_cash":491.75,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1405,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1053.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":702.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1194.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":632.25,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":772.75,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT N-HF/GN7.6-12.5CM","code_information":[{"code":"12044","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":151.73,"maximum":7221,"gross_charge":1405,"discounted_cash":491.75,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1067.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":843,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1405,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1053.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":632.25,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1194.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":660.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":508.33,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1160.82,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":576.05,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":379.35,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT N-HF/GN12.6-20CM","code_information":[{"code":"12045","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":632.25,"maximum":1405,"gross_charge":1405,"discounted_cash":491.75,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1405,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1053.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":702.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1194.25,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":632.25,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":772.75,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT N-HF/GN12.6-20CM","code_information":[{"code":"12045","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":228.07,"maximum":7221,"gross_charge":1405,"discounted_cash":491.75,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1067.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":843,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":913.25,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":983.5,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1405,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1053.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":632.25,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1194.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":660.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":508.33,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1160.82,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":576.05,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":772.75,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":379.35,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"INTMD RPR N-HF/GENIT20.1-30","code_information":[{"code":"12046","type":"CPT"}],"standard_charges":[{"minimum":228.07,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"INTMD RPR N-HF/GENIT >30.0CM","code_information":[{"code":"12047","type":"CPT"}],"standard_charges":[{"minimum":397.85,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT FACE 2.5CM/<","code_information":[{"code":"12051","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1284.3,"maximum":2854,"gross_charge":2854,"discounted_cash":998.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1997.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1855.1,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1855.1,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1997.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1855.1,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1997.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2854,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2140.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1427,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2425.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1569.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1569.7,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1284.3,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1569.7,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT FACE 2.5CM/<","code_information":[{"code":"12051","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":2854,"gross_charge":2854,"discounted_cash":998.9,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1997.8,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2169.04,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":174.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":347.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":148.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":369.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":269.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1712.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1997.8,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1855.1,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1855.1,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1997.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1855.1,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1712.4,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1997.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2854,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2140.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":1855.1,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":1855.1,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1284.3,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2425.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1341.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1569.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1569.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1032.58,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2357.98,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1170.14,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1569.7,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":770.58,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT FACE 2.6-5CM","code_information":[{"code":"12052","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1510.65,"maximum":3357,"gross_charge":3357,"discounted_cash":1174.95,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2349.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2182.05,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2182.05,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2349.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2182.05,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2349.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3357,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2517.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1678.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2853.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1846.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1846.35,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1510.65,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1846.35,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT FACE 2.6-5CM","code_information":[{"code":"12052","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":3357,"gross_charge":3357,"discounted_cash":1174.95,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2349.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2551.32,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":174.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":347.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":148.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":369.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":269.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2014.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2349.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2182.05,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2182.05,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2349.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2182.05,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":2014.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2349.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3357,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2517.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":2182.05,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":2182.05,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1510.65,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":2853.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1577.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1846.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1846.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1214.57,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2773.56,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1376.37,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1846.35,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":906.39,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT FACE 5.1-7.5CM","code_information":[{"code":"12053","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1631.7,"maximum":3626,"gross_charge":3626,"discounted_cash":1269.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2538.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2356.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2356.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2538.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2356.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2538.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3626,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2719.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1813,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3082.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1994.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1994.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1631.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1994.3,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT FACE 5.1-7.5CM","code_information":[{"code":"12053","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":92.7,"maximum":3626,"gross_charge":3626,"discounted_cash":1269.1,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2538.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2755.76,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":174.37,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":347.12,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":148.53,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":369.72,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":269.62,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":92.7,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2175.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":154,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":387,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2538.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2356.9,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2356.9,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2538.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2700,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2356.9,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":2175.6,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2538.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3626,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2719.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":2356.9,"methodology":"fee schedule"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":2356.9,"methodology":"fee schedule"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1631.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3082.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1704.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1994.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1994.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1311.89,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2995.81,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1486.66,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1994.3,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":979.02,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT FACE 7.6-12.5 CM","code_information":[{"code":"12054","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1661.85,"maximum":3693,"gross_charge":3693,"discounted_cash":1292.55,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2585.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2400.45,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2400.45,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2585.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2400.45,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2585.1,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3693,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2769.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1846.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3139.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2031.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2031.15,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1661.85,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2031.15,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT FACE 7.6-12.5 CM","code_information":[{"code":"12054","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"gross_charge":3693,"discounted_cash":1292.55,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2585.1,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":2806.68,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":151.73,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":2215.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":2585.1,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":2400.45,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2400.45,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":2585.1,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":2400.45,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":2585.1,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":3693,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":2769.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":1661.85,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":3139.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":1735.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2031.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2031.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1336.13,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":3051.16,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":1514.13,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2031.15,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":997.11,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR INT FACE 12.6-20CM","code_information":[{"code":"12055","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":2281.5,"maximum":5070,"gross_charge":5070,"discounted_cash":1774.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3549,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3295.5,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3295.5,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3549,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3295.5,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3549,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5070,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3802.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":2535,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4309.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2788.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2788.5,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2281.5,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2788.5,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR INT FACE 12.6-20CM","code_information":[{"code":"12055","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"gross_charge":5070,"discounted_cash":1774.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3549,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":3853.2,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":3042,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":3549,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":3295.5,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":3295.5,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":3549,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":3295.5,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":3549,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":5070,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":3802.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":2281.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":4309.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":2382.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2788.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":2788.5,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":1834.33,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":4188.84,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":2078.7,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":2788.5,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":1368.9,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"INTMD RPR FACE/MM 20.1-30.0","code_information":[{"code":"12056","type":"CPT"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"INTMD RPR FACE/MM >30.0 CM","code_information":[{"code":"12057","type":"CPT"}],"standard_charges":[{"minimum":150.52,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"ACUTE MAJOR EYE INFECTIONS WITH CC/MCC","code_information":[{"code":"121","type":"MS-DRG"}],"standard_charges":[{"minimum":7543.86,"maximum":34052.11,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":16135.46,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13901,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":17358,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":27395,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":15753,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15716.36,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":15716.36,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":14668.6,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":15716.36,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":9422,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":13842,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":13842,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":14609,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":14144.72,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":34052.11,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":21494,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":21494,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":7543.86,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":15716.36,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":9222,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":15651,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":11623,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":17388,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":17388,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":15716.36,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10687.13,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10477.57,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":10791.9,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":10477.57,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":10477.57,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":10582.35,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":11211,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":10477.57,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":10477.57,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":10137.05,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":12573.09,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":11211,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":11001.45,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":10687.13,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1211","type":"APR-DRG"}],"standard_charges":[{"minimum":6741,"maximum":24941.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7078.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7752.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":18605.16,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6741,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":16178.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6741,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6875.82,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6875.82,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24941.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6875.82,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":16515.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":24941.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6943.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6943.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16650.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6943.23,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1212","type":"APR-DRG"}],"standard_charges":[{"minimum":9392,"maximum":34750.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9861.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10800.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":25921.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9392,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":22540.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9392,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9579.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9579.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":34750.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9579.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":23010.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":34750.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9673.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9673.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":23198.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9673.76,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1213","type":"APR-DRG"}],"standard_charges":[{"minimum":19268,"maximum":71291.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":20231.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22158.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":53179.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19268,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":46243.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19268,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":19653.36,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19653.36,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":71291.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19653.36,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":47206.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":71291.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19846.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":19846.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":47591.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19846.04,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1214","type":"APR-DRG"}],"standard_charges":[{"minimum":35627,"maximum":131819.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":37408.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":40971.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":98330.52,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":35627,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":85504.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":35627,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":36339.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":36339.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":131819.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":36339.54,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":87286.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":131819.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":36695.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":36695.81,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":87998.69,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":36695.81,"methodology":"case rate"}]}]},{"description":"ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC","code_information":[{"code":"122","type":"MS-DRG"}],"standard_charges":[{"minimum":4833.03,"maximum":21815.73,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":10337.3,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":7837,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":10122,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":15975,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":9186,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10068.8,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":10068.8,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":9397.55,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":10068.8,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":5494,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":8072,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":8072,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":8519,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":9061.92,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":21815.73,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":12534,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":12534,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":4833.03,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10068.8,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":5359,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":9127,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":6778,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":10139,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":10139,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":10068.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":6846.79,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":6712.53,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":6913.91,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":6712.53,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":6712.53,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":6779.66,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":7182.41,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":6712.53,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":6712.53,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":6494.38,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":8055.04,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":7182.41,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":7048.16,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":6846.79,"methodology":"case rate"}]}]},{"description":"NEUROLOGICAL EYE DISORDERS","code_information":[{"code":"123","type":"MS-DRG"}],"standard_charges":[{"minimum":5531.28,"maximum":24967.54,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":11830.78,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9006,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":11986,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":18916,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":10878,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11523.48,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":11523.48,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":10755.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":11523.48,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":6506,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":9558,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":9558,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":10087,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":10371.14,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":24967.54,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":14842,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":14842,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5531.28,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11523.48,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":5787,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":10807,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":8026,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":12006,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":12006,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":11523.48,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7835.97,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7682.32,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":7912.79,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":7682.32,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":7682.32,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":7759.15,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8220.09,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7682.32,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7682.32,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":7432.65,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9218.79,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8220.09,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8066.44,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":7835.97,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT","code_information":[{"code":"124","type":"MS-DRG"}],"standard_charges":[{"minimum":8330.43,"maximum":37602.63,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":17817.87,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":15891,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":19458,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":30708,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":17659,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17355.06,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":17355.06,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":16198.06,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":17355.06,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":10562,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":15516,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":15516,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":16376,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":15619.56,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":37602.63,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":24093,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":24093,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8330.43,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17355.06,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":9515,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":17544,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":13029,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":19491,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":19491,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":17355.06,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11801.45,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11570.04,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":11917.15,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":11570.04,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":11570.04,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":11685.75,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":12379.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":11570.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":11570.04,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11194.02,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":13884.05,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":12379.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":12148.55,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":11801.45,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF THE EYE WITHOUT MCC","code_information":[{"code":"125","type":"MS-DRG"}],"standard_charges":[{"minimum":5657.07,"maximum":25535.35,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":12099.83,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":9781,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":12322,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":19446,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":11182,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11785.55,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":11785.55,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":10999.85,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":11785.55,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":6688,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":9826,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":9826,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":10370,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":10607,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":25535.35,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":15257,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":15257,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5657.07,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11785.55,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":5740,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":11110,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":8250,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":12343,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":12343,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":11785.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":8014.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7857.03,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":8092.75,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":7857.03,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":7857.03,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":7935.61,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8407.03,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7857.03,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7857.03,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":7601.68,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9428.44,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8407.03,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8249.89,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":8014.18,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1301","type":"APR-DRG"}],"standard_charges":[{"minimum":19091,"maximum":70636.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":20045.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21954.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":52691.16,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19091,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":45818.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19091,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":19472.82,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19472.82,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":70636.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19472.82,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":46772.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":70636.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19663.73,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":19663.73,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":47154.77,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19663.73,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1302","type":"APR-DRG"}],"standard_charges":[{"minimum":22298,"maximum":82502.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":23412.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25642.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":61542.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22298,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":53515.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22298,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":22743.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22743.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":82502.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22743.96,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":54630.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":82502.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22966.94,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":22966.94,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":55076.06,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":22966.94,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1303","type":"APR-DRG"}],"standard_charges":[{"minimum":25505,"maximum":94368.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":26780.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":29330.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":70393.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":25505,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":61212,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":25505,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":26015.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":26015.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":94368.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":26015.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":62487.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":94368.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":26270.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":26270.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":62997.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":26270.15,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1304","type":"APR-DRG"}],"standard_charges":[{"minimum":37562,"maximum":138979.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":39440.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":43196.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":103671.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":37562,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":90148.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":37562,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":38313.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":38313.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":138979.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38313.24,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":92026.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":138979.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":38688.86,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":38688.86,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":92778.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":38688.86,"methodology":"case rate"}]}]},{"description":"CMPLX RPR TRUNK 1.1-2.5 CM","code_information":[{"code":"13100","type":"CPT"}],"standard_charges":[{"minimum":228.07,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":512.19,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC REPAIR COMP TRNK 2.6-7.5CM","code_information":[{"code":"13101","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":666,"maximum":1480,"gross_charge":1480,"discounted_cash":518,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1480,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1110,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":740,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1258,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":666,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR COMP TRNK 2.6-7.5CM","code_information":[{"code":"13101","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":228.07,"maximum":9029,"gross_charge":1480,"discounted_cash":518,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1124.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":512.19,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":888,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1480,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1110,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":666,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1258,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":695.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":535.47,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1222.78,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":606.8,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":399.6,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC REPAIR COMP TRNK ADDL 5 CM/<","code_information":[{"code":"13102","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":219.6,"maximum":488,"gross_charge":488,"discounted_cash":170.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":341.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":317.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":317.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":341.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":317.2,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":341.6,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":488,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":366,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":244,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":414.8,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":268.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":268.4,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":219.6,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":268.4,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR COMP TRNK ADDL 5 CM/<","code_information":[{"code":"13102","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":53.68,"maximum":4487,"gross_charge":488,"discounted_cash":170.8,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":341.6,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":370.88,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":512.19,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":292.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":341.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":317.2,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":317.2,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":958,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":341.6,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":317.2,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":341.6,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":488,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":366,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":219.6,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":414.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":229.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.37,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":53.68,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":268.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":268.4,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":71.94,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":176.56,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":403.19,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":200.08,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":53.68,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":71.94,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":53.68,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":268.4,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":54.76,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":54.76,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":167.49,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":54.76,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":73.55,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":167.49,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":53.68,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":53.68,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":71.94,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":53.68,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":131.76,"methodology":"fee schedule"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1311","type":"APR-DRG"}],"standard_charges":[{"minimum":6241,"maximum":23091.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6553.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7177.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":17225.16,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6241,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":14978.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6241,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6365.82,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6365.82,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23091.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6365.82,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":15290.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23091.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6428.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6428.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":15415.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6428.23,"methodology":"case rate"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1312","type":"APR-DRG"}],"standard_charges":[{"minimum":10933,"maximum":40452.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11479.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12572.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":30175.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10933,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":26239.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10933,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11151.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11151.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":40452.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11151.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":26785.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":40452.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11260.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11260.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":27004.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11260.99,"methodology":"case rate"}]}]},{"description":"HC REPAIR COMP S/A/L 1.1-2.5CM","code_information":[{"code":"13120","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":827.55,"maximum":1839,"gross_charge":1839,"discounted_cash":643.65,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1839,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1379.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":919.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1563.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":827.55,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1011.45,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR COMP S/A/L 1.1-2.5CM","code_information":[{"code":"13120","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":228.07,"maximum":7221,"gross_charge":1839,"discounted_cash":643.65,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1397.64,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1103.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1839,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1379.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":827.55,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1563.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":864.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":665.36,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1519.39,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":753.99,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":496.53,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC REPAIR COMP S/A/L 2.6-7.5CM","code_information":[{"code":"13121","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":918.45,"maximum":2041,"gross_charge":2041,"discounted_cash":714.35,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1428.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1326.65,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1326.65,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1428.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1326.65,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1428.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2041,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1530.75,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":1020.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1734.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1122.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1122.55,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":918.45,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1122.55,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR COMP S/A/L 2.6-7.5CM","code_information":[{"code":"13121","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":228.07,"maximum":9029,"gross_charge":2041,"discounted_cash":714.35,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1428.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1551.16,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1224.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1428.7,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1326.65,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1326.65,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1428.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1326.65,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1428.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":2041,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1530.75,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":918.45,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1734.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":959.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1122.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1122.55,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":738.44,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1686.28,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":836.81,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1122.55,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":551.07,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC REPAIR COMP S/A/L EA 5CM/<","code_information":[{"code":"13122","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":85.95,"maximum":191,"gross_charge":191,"discounted_cash":66.85,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":133.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":124.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":124.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":133.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":124.15,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":133.7,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":191,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":143.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":95.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":162.35,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":105.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":105.05,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":85.95,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":105.05,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR COMP S/A/L EA 5CM/<","code_information":[{"code":"13122","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":21.01,"maximum":4487,"gross_charge":191,"discounted_cash":66.85,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":133.7,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":145.16,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":114.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":133.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":124.15,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":124.15,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":958,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":133.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":124.15,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":133.7,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":191,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":143.25,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":85.95,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":162.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":89.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.07,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21.01,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":105.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":105.05,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":28.16,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":69.11,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":157.81,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":78.31,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21.01,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":28.16,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21.01,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":105.05,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":21.44,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21.44,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":65.56,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21.44,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":28.79,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":65.56,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21.01,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":21.01,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":28.16,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21.01,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":51.57,"methodology":"fee schedule"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1313","type":"APR-DRG"}],"standard_charges":[{"minimum":14777,"maximum":54674.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":15515.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":16993.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":40784.52,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":14777,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":35464.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":14777,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":15072.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15072.54,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":54674.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15072.54,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":36203.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":54674.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":15220.31,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":15220.31,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":36499.19,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":15220.31,"methodology":"case rate"}]}]},{"description":"HC REPAIR COMP FACE 1.1-2.5CM","code_information":[{"code":"13131","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":209.7,"maximum":466,"gross_charge":466,"discounted_cash":163.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":326.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":302.9,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":302.9,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":326.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":302.9,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":326.2,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":466,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":349.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":233,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":396.1,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":256.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":256.3,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":209.7,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":256.3,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR COMP FACE 1.1-2.5CM","code_information":[{"code":"13131","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":125.82,"maximum":7221,"gross_charge":466,"discounted_cash":163.1,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":616.28,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":326.2,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":354.16,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":268.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":651.8,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":293.95,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":702.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":533.58,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":578.01,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":279.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":326.2,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":302.9,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":560.25,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":302.9,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":326.2,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":302.9,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":326.2,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":540.24,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":466,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":349.5,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1300.59,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":288.13,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":209.7,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":396.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":219.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":600.27,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":173.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":256.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":256.3,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":231.8,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":168.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":385.01,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":191.06,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":256.3,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":153.53,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":206.21,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":469.62,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":201.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":150.52,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":408.18,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":412.19,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":404.18,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":400.18,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":480.22,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":125.82,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":428.19,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":420.19,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":408.18,"methodology":"case rate"}]}]},{"description":"HC REPAIR COMP FACE 2.6-7.5CM","code_information":[{"code":"13132","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":666,"maximum":1480,"gross_charge":1480,"discounted_cash":518,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1480,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1110,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":740,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1258,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":666,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR COMP FACE 2.6-7.5CM","code_information":[{"code":"13132","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":228.07,"maximum":9029,"gross_charge":1480,"discounted_cash":518,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1124.8,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":888,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":962,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1036,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1480,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1110,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":666,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1258,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":695.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":535.47,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1222.78,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":606.8,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":814,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":399.6,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC REPAIR COMP FACE EA 5CM/<","code_information":[{"code":"13133","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":87.3,"maximum":194,"gross_charge":194,"discounted_cash":67.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":135.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":126.1,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":126.1,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":135.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":126.1,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":135.8,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":194,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":145.5,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":97,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":164.9,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":106.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":106.7,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":87.3,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":106.7,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR COMP FACE EA 5CM/<","code_information":[{"code":"13133","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":21.34,"maximum":4487,"gross_charge":194,"discounted_cash":67.9,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":896,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":135.8,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":147.44,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":116.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":100,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":135.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":126.1,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":126.1,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":958,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":135.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1494,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":126.1,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":135.8,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":942.3,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":194,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":145.5,"methodology":"fee schedule"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":4487,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":87.3,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":164.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":91.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.41,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21.34,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":106.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":106.7,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":28.6,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":70.19,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":160.29,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":79.54,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21.34,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":28.6,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21.34,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":106.7,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":21.77,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21.77,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":66.59,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21.77,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":29.24,"methodology":"fee schedule"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":66.59,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":21.34,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":21.34,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":28.6,"methodology":"fee schedule"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":21.34,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":52.38,"methodology":"fee schedule"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1314","type":"APR-DRG"}],"standard_charges":[{"minimum":19864,"maximum":73496.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":20857.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":22843.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":54824.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":19864,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":47673.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":19864,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":20261.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":20261.28,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":73496.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20261.28,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":48666.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":73496.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":20459.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":20459.92,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":49064.08,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":20459.92,"methodology":"case rate"}]}]},{"description":"HC REPAIRCOMP E/N/E/L 1.1-2.5","code_information":[{"code":"13151","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":687.15,"maximum":1527,"gross_charge":1527,"discounted_cash":534.45,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1068.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":992.55,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":992.55,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1068.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":992.55,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1068.9,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1527,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1145.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":763.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1297.95,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":839.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":839.85,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":687.15,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":839.85,"methodology":"fee schedule"}]}]},{"description":"HC REPAIRCOMP E/N/E/L 1.1-2.5","code_information":[{"code":"13151","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":228.07,"maximum":9029,"gross_charge":1527,"discounted_cash":534.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1068.9,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1160.52,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":512.19,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":916.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1068.9,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":992.55,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":992.55,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1068.9,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":992.55,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1068.9,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1527,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1145.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":687.15,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1297.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":717.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":839.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":839.85,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":552.47,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1261.61,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":626.07,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":839.85,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":412.29,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"HC REPAIR COMP E/N/E/L 2.6-7.5","code_information":[{"code":"13152","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":827.55,"maximum":1839,"gross_charge":1839,"discounted_cash":643.65,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1839,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1379.25,"methodology":"fee schedule"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_dollar":919.5,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1563.15,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":827.55,"methodology":"fee schedule"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1011.45,"methodology":"fee schedule"}]}]},{"description":"HC REPAIR COMP E/N/E/L 2.6-7.5","code_information":[{"code":"13152","type":"CPT"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":228.07,"maximum":9029,"gross_charge":1839,"discounted_cash":643.65,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":944.2,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_dollar":1397.64,"methodology":"fee schedule"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":417.5,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":1013.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":457.26,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":1093.44,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":830.02,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":512.19,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":875.84,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_dollar":1103.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":858.37,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_dollar":1195.35,"methodology":"fee schedule"},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_dollar":1287.3,"methodology":"fee schedule"},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":827.71,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_dollar":1839,"methodology":"fee schedule"},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_dollar":1379.25,"methodology":"fee schedule"},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":1992.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":441.45,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":827.55,"methodology":"fee schedule"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_dollar":1563.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_dollar":864.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":919.68,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.47,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":262.28,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":351.23,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_dollar":665.36,"methodology":"fee schedule"},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":1519.39,"methodology":"fee schedule"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_dollar":753.99,"methodology":"fee schedule"},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_dollar":1011.45,"methodology":"fee schedule"},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":232.63,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":312.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":711.58,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":305.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":228.07,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":625.38,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":631.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":619.25,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":613.12,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":735.74,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_dollar":496.53,"methodology":"fee schedule"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":656.04,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":643.78,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":625.38,"methodology":"case rate"}]}]},{"description":"CMPLX RPR E/N/E/L ADDL 5CM/<","code_information":[{"code":"13153","type":"CPT"}],"standard_charges":[{"minimum":397.85,"maximum":5252,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":397.85,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":1955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2172,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"LATE CLOSURE OF WOUND","code_information":[{"code":"13160","type":"CPT"}],"standard_charges":[{"minimum":745.88,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":2435.25,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1321","type":"APR-DRG"}],"standard_charges":[{"minimum":2262,"maximum":8369.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2375.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2601.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6243.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5428.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2307.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2307.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8369.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2307.24,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5541.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8369.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2329.86,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2329.86,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5587.14,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2329.86,"methodology":"case rate"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1322","type":"APR-DRG"}],"standard_charges":[{"minimum":4265,"maximum":15780.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4478.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4904.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11771.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4265,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10236,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4265,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4350.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4350.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15780.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4350.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10449.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15780.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4392.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4392.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10534.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4392.95,"methodology":"case rate"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1323","type":"APR-DRG"}],"standard_charges":[{"minimum":7233,"maximum":26762.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7594.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8317.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":19963.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7233,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":17359.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7233,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7377.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7377.66,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":26762.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7377.66,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":17720.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":26762.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7449.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7449.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":17865.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7449.99,"methodology":"case rate"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1324","type":"APR-DRG"}],"standard_charges":[{"minimum":12095,"maximum":44751.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":12699.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13909.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":33382.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12095,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":29028,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12095,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":12336.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12336.9,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":44751.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12336.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":29632.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":44751.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12457.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":12457.85,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":29874.65,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12457.85,"methodology":"case rate"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1331","type":"APR-DRG"}],"standard_charges":[{"minimum":2506,"maximum":9272.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2631.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2881.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6916.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2506,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6014.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2506,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2556.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2556.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":9272.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2556.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6139.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":9272.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2581.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2581.18,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":6189.82,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2581.18,"methodology":"case rate"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1332","type":"APR-DRG"}],"standard_charges":[{"minimum":3904,"maximum":14444.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4099.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4489.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10775.04,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3904,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9369.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3904,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3982.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3982.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14444.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3982.08,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9564.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14444.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4021.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4021.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9642.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4021.12,"methodology":"case rate"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1333","type":"APR-DRG"}],"standard_charges":[{"minimum":7375,"maximum":27287.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7743.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8481.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":20355,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7375,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":17700,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7375,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7522.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7522.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27287.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7522.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":18068.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":27287.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7596.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7596.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":18216.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7596.25,"methodology":"case rate"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1334","type":"APR-DRG"}],"standard_charges":[{"minimum":10709,"maximum":39623.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":11244.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12315.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":29556.84,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10709,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":25701.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10709,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":10923.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":10923.18,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":39623.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10923.18,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":26237.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":39623.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11030.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11030.27,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":26451.23,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11030.27,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1341","type":"APR-DRG"}],"standard_charges":[{"minimum":3356,"maximum":12417.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3523.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3859.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":9262.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3356,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8054.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3356,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3423.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3423.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12417.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3423.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8222.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12417.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3456.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3456.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8289.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3456.68,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1342","type":"APR-DRG"}],"standard_charges":[{"minimum":3875,"maximum":14337.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4068.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4456.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10695,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3875,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9300,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3875,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3952.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3952.5,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14337.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3952.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9493.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14337.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3991.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3991.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9571.25,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3991.25,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1343","type":"APR-DRG"}],"standard_charges":[{"minimum":5790,"maximum":21423,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6079.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6658.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":15980.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5790,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":13896,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5790,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5905.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5905.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21423,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5905.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":14185.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21423,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5963.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5963.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":14301.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5963.7,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1344","type":"APR-DRG"}],"standard_charges":[{"minimum":11451,"maximum":42368.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":12023.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13168.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":31604.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11451,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":27482.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11451,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11680.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11680.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":42368.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11680.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":28054.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":42368.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11794.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11794.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":28283.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11794.53,"methodology":"case rate"}]}]},{"description":"SINUS AND MASTOID PROCEDURES WITH CC/MCC","code_information":[{"code":"135","type":"MS-DRG"}],"standard_charges":[{"minimum":14520.22,"maximum":65542.62,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":31057.12,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":27803,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":35981,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":56784,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":32654,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30250.44,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":30250.44,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":28233.75,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":30250.44,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":19530,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":28692,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":28692,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":30281,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":27225.4,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":65542.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":44552,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":44552,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":14520.22,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30250.44,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":19090,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":32441,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":24092,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":36041,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":36041,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":30250.44,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":20570.3,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20166.96,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":20771.97,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":20166.96,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":20166.96,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":20368.63,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":21578.65,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":20166.96,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":20166.96,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":19511.54,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":24200.36,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":21578.65,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":21175.31,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":20570.3,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1351","type":"APR-DRG"}],"standard_charges":[{"minimum":3599,"maximum":13316.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3778.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4138.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":9933.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3599,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8637.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3599,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3670.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3670.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13316.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3670.98,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8817.55,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13316.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3706.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3706.97,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8889.53,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3706.97,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1352","type":"APR-DRG"}],"standard_charges":[{"minimum":4768,"maximum":17641.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5006.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5483.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":13159.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4768,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11443.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4768,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4863.36,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4863.36,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17641.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4863.36,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":11681.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17641.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4911.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4911.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":11776.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4911.04,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1353","type":"APR-DRG"}],"standard_charges":[{"minimum":5701,"maximum":21093.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5986.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6556.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":15734.76,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5701,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":13682.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5701,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5815.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5815.02,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21093.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5815.02,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":13967.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21093.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5872.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5872.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":14081.47,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5872.03,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1354","type":"APR-DRG"}],"standard_charges":[{"minimum":9380,"maximum":34706,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":9849,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":10787,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":25888.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9380,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":22512,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9380,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":9567.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9567.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":34706,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9567.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":22981,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":34706,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9661.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":9661.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":23168.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":9661.4,"methodology":"case rate"}]}]},{"description":"SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"136","type":"MS-DRG"}],"standard_charges":[{"minimum":6509.61,"maximum":29383.64,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":13923.33,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":13164,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":14598,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":23038,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":13248,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13561.68,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":13561.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":12657.57,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":13561.68,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":7923,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":11641,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":11641,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":12285,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":12205.52,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":29383.64,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":18075,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":18075,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":6509.61,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13561.68,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":7517,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":13162,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":9774,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":14622,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":14622,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":13561.68,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9221.95,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9041.12,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":9312.36,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":9041.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":9041.12,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":9131.54,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":9674,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":9041.12,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":9041.12,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":8747.29,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":10849.35,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":9674,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":9493.18,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":9221.95,"methodology":"case rate"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1361","type":"APR-DRG"}],"standard_charges":[{"minimum":4292,"maximum":15880.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4506.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4935.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":11845.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4292,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10300.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4292,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4377.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4377.84,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15880.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4377.84,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10515.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":15880.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4420.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4420.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10601.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4420.76,"methodology":"case rate"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1362","type":"APR-DRG"}],"standard_charges":[{"minimum":5708,"maximum":21119.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5993.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6564.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":15754.08,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5708,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":13699.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5708,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5822.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5822.16,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21119.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5822.16,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":13984.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21119.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5879.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5879.24,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":14098.76,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5879.24,"methodology":"case rate"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1363","type":"APR-DRG"}],"standard_charges":[{"minimum":8073,"maximum":29870.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8476.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9283.95,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":22281.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8073,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":19375.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8073,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":8234.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8234.46,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":29870.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8234.46,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":19778.85,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":29870.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8315.19,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":8315.19,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":19940.31,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8315.19,"methodology":"case rate"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1364","type":"APR-DRG"}],"standard_charges":[{"minimum":11489,"maximum":42509.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":12063.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13212.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":31709.64,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11489,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":27573.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11489,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":11718.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11718.78,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":42509.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11718.78,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":28148.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":42509.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11833.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":11833.67,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":28377.83,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11833.67,"methodology":"case rate"}]}]},{"description":"MOUTH PROCEDURES WITH CC/MCC","code_information":[{"code":"137","type":"MS-DRG"}],"standard_charges":[{"minimum":8859.85,"maximum":39992.36,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":18950.23,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":17013,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":20871,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":32938,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":18941,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18458.01,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":18458.01,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":17227.48,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":18458.01,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":11329,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":16643,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":16643,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":17565,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":16612.21,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":39992.36,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":25843,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":25843,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8859.85,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18458.01,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":10831,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":18818,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":13975,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":20906,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":20906,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":18458.01,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12551.45,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12305.34,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":12674.51,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":12305.34,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":12305.34,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":12428.4,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":13166.72,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12305.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12305.34,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11905.42,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":14766.41,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":13166.72,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":12920.61,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":12551.45,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1371","type":"APR-DRG"}],"standard_charges":[{"minimum":3056,"maximum":11307.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3208.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3514.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8434.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3056,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7334.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3056,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3117.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3117.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11307.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3117.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7487.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11307.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3147.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3147.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7548.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3147.68,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1372","type":"APR-DRG"}],"standard_charges":[{"minimum":4381,"maximum":16209.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4600.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5038.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":12091.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4381,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":10514.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4381,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4468.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4468.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16209.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4468.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":10733.45,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":16209.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4512.43,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4512.43,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":10821.07,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4512.43,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1373","type":"APR-DRG"}],"standard_charges":[{"minimum":6396,"maximum":23665.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6715.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7355.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":17652.96,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6396,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":15350.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6396,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6523.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6523.92,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23665.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6523.92,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":15670.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23665.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6587.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6587.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":15798.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6587.88,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1374","type":"APR-DRG"}],"standard_charges":[{"minimum":11816,"maximum":43719.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":12406.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":13588.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":32612.16,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":11816,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":28358.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":11816,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":12052.32,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12052.32,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":43719.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12052.32,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":28949.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":43719.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":12170.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":12170.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":29185.52,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":12170.48,"methodology":"case rate"}]}]},{"description":"MOUTH PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"138","type":"MS-DRG"}],"standard_charges":[{"minimum":5588.86,"maximum":25227.48,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":11953.95,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":10032,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":12140,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":19159,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":11017,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11643.45,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":11643.45,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":10867.22,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":11643.45,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":6589,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":9681,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":9681,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":10217,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":10479.11,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":25227.48,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":15032,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":15032,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":5588.86,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11643.45,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":6231,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":10946,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":8128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":12160,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":12160,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":11643.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7917.55,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7762.3,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":7995.17,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":7762.3,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":7762.3,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":7839.93,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":8305.67,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":7762.3,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":7762.3,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":7510.03,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":9314.76,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":8305.67,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":8150.42,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":7917.55,"methodology":"case rate"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1381","type":"APR-DRG"}],"standard_charges":[{"minimum":1568,"maximum":5801.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":1646.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1803.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":4327.68,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1568,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":3763.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1568,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1599.36,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1599.36,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5801.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1599.36,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":3841.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":5801.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1615.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":1615.04,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":3872.96,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1615.04,"methodology":"case rate"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1382","type":"APR-DRG"}],"standard_charges":[{"minimum":2187,"maximum":8091.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2296.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2515.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":6036.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2187,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":5248.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2187,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2230.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2230.74,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8091.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2230.74,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":5358.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":8091.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2252.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2252.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":5401.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2252.61,"methodology":"case rate"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1383","type":"APR-DRG"}],"standard_charges":[{"minimum":3735,"maximum":13819.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3921.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4295.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10308.6,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3735,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8964,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3735,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3809.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3809.7,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13819.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3809.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9150.75,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":13819.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3847.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3847.05,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9225.45,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3847.05,"methodology":"case rate"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1384","type":"APR-DRG"}],"standard_charges":[{"minimum":8349,"maximum":30891.3,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8766.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9601.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":23043.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8349,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":20037.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8349,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":8515.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8515.98,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":30891.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8515.98,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":20455.05,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":30891.3,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8599.47,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":8599.47,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":20622.03,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8599.47,"methodology":"case rate"}]}]},{"description":"SALIVARY GLAND PROCEDURES","code_information":[{"code":"139","type":"MS-DRG"}],"standard_charges":[{"minimum":8549,"maximum":39346.36,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":18644.12,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":14266,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":20489,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":32336,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":18595,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18159.86,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":18159.86,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":16949.2,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":18159.86,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":11121,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":16339,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":16339,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":17244,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":16343.87,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":39346.36,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":25370,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":25370,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":8716.74,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18159.86,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":8549,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":18474,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":13719,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":20524,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":20524,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":18159.86,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12348.71,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12106.57,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":12469.77,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":12106.57,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":12106.57,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":12227.64,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":12954.03,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":12106.57,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":12106.57,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":11713.11,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":14527.89,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":12954.03,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":12711.9,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":12348.71,"methodology":"case rate"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1391","type":"APR-DRG"}],"standard_charges":[{"minimum":1874,"maximum":6933.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":1967.7,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2155.1,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":5172.24,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1874,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":4497.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1874,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1911.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1911.48,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6933.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1911.48,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":4591.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6933.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1930.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":1930.22,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":4628.78,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1930.22,"methodology":"case rate"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1392","type":"APR-DRG"}],"standard_charges":[{"minimum":2912,"maximum":10774.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3057.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3348.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8037.12,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2912,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6988.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2912,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2970.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2970.24,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10774.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2970.24,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7134.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10774.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2999.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2999.36,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7192.64,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2999.36,"methodology":"case rate"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1393","type":"APR-DRG"}],"standard_charges":[{"minimum":4604,"maximum":17034.8,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4834.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5294.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":12707.04,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4604,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":11049.6,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4604,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":4696.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4696.08,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17034.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4696.08,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":11279.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":17034.8,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4742.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4742.12,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":11371.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4742.12,"methodology":"case rate"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1394","type":"APR-DRG"}],"standard_charges":[{"minimum":7903,"maximum":29241.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":8298.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":9088.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":21812.28,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7903,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":18967.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7903,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":8061.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8061.06,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":29241.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8061.06,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":19362.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":29241.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":8140.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":8140.09,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":19520.41,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":8140.09,"methodology":"case rate"}]}]},{"description":"MAJOR HEAD AND NECK PROCEDURES WITH MCC","code_information":[{"code":"140","type":"MS-DRG"}],"standard_charges":[{"minimum":24684.28,"maximum":111422.06,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":52796.92,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":47153,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":63112,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":99602,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":57276,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51425.57,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":51425.57,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":47997.2,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":51425.57,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":34257,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":50327,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":50327,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":53115,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":46283.01,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":111422.06,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":78147,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":78147,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":24684.28,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":51425.57,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":27195,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":56904,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":42258,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":63218,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":63218,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":51425.57,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":34969.39,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":34283.71,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":35312.23,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":34283.71,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":34283.71,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":34626.55,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":36683.57,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":34283.71,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":34283.71,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":33169.49,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":41140.46,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":36683.57,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":35997.9,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":34969.39,"methodology":"case rate"}]}]},{"description":"TIS TRNFR TRUNK 10 SQ CM/<","code_information":[{"code":"14000","type":"CPT"}],"standard_charges":[{"minimum":745.88,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1846.76,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"TIS TRNFR TRUNK 10.1-30SQCM","code_information":[{"code":"14001","type":"CPT"}],"standard_charges":[{"minimum":745.88,"maximum":9029,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1846.76,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1401","type":"APR-DRG"}],"standard_charges":[{"minimum":2872,"maximum":10626.4,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3015.6,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3302.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":7926.72,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2872,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6892.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2872,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2929.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2929.44,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10626.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2929.44,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7036.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":10626.4,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2958.16,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2958.16,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7093.84,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2958.16,"methodology":"case rate"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1402","type":"APR-DRG"}],"standard_charges":[{"minimum":3330,"maximum":12321,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3496.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3829.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":9190.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3330,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7992,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3330,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3396.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3396.6,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12321,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3396.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8158.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12321,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3429.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3429.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8225.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3429.9,"methodology":"case rate"}]}]},{"description":"TIS TRNFR S/A/L 10 SQ CM/<","code_information":[{"code":"14020","type":"CPT"}],"standard_charges":[{"minimum":745.88,"maximum":9029,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1846.76,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"TIS TRNFR S/A/L 10.1-30 SQCM","code_information":[{"code":"14021","type":"CPT"}],"standard_charges":[{"minimum":745.88,"maximum":9029,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1846.76,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1403","type":"APR-DRG"}],"standard_charges":[{"minimum":3905,"maximum":14448.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":4100.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4490.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":10777.8,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3905,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":9372,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3905,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3983.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3983.1,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14448.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3983.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":9567.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":14448.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":4022.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":4022.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":9645.35,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":4022.15,"methodology":"case rate"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1404","type":"APR-DRG"}],"standard_charges":[{"minimum":5731,"maximum":21204.7,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6017.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6590.65,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":15817.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5731,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":13754.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5731,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5845.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5845.62,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21204.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5845.62,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":14040.95,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":21204.7,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5902.93,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5902.93,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":14155.57,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5902.93,"methodology":"case rate"}]}]},{"description":"TIS TRNFR F/C/C/M/N/A/G/H/F","code_information":[{"code":"14040","type":"CPT"}],"standard_charges":[{"minimum":745.88,"maximum":7221,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1438,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1195,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1846.76,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":2875,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":7221,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":2609,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1285,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":1980,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1675,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1361.7,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5185,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"TIS TRNFR F/C/C/M/N/A/G/H/F","code_information":[{"code":"14041","type":"CPT"}],"standard_charges":[{"minimum":745.88,"maximum":9029,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"median_amount":1960.44,"10th_percentile":1960.44,"90th_percentile":1960.44,"count":"1 through 10","methodology":"percent of total billed charges"},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1846.76,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"TIS TRNFR E/N/E/L 10 SQ CM/<","code_information":[{"code":"14060","type":"CPT"}],"standard_charges":[{"minimum":745.88,"maximum":9029,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1846.76,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"TIS TRNFR E/N/E/L10.1-30SQCM","code_information":[{"code":"14061","type":"CPT"}],"standard_charges":[{"minimum":745.88,"maximum":9029,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":2821.57,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|HMO","standard_charge_dollar":1648,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|KelseyCare","standard_charge_dollar":1369,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Aetna","plan_name":"Commercial|Transplant","standard_charge_percentage":76,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - TX","plan_name":"Commercial|Blue Advantage Exchange","standard_charge_dollar":1363.1,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|HMO","standard_charge_dollar":3310.39,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|MyBlue Health Exchange","standard_charge_dollar":1492.92,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|PPO Trad","standard_charge_dollar":3570.03,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Premier","standard_charge_dollar":2709.98,"methodology":"case rate"},{"payer_name":"BCBS - TX","plan_name":"Commercial|Transplant","standard_charge_dollar":1846.76,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":2864.28,"methodology":"case rate"},{"payer_name":"Cigna Lifesource","plan_name":"Commercial|Transplant","standard_charge_percentage":60,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":3594,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9029,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":2565.07,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":1609,"methodology":"fee schedule"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":2250,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1518.3,"methodology":"case rate"},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":2473.46,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":5954.62,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":5252,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":1319.18,"methodology":"case rate"},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":1984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Optum","standard_charge_percentage":47,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":2968,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":2748.28,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.17,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":857.76,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":1148.66,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicaid|STAR","standard_charge_percentage":36.18,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"OPTUM","plan_name":"Medicaid|STARPLUS","standard_charge_percentage":82.62,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":41,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":760.8,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":1021.86,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":2327.15,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":999.48,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":745.88,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1868.83,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":1887.16,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":1850.51,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":1832.19,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":2198.63,"methodology":"case rate"},{"payer_name":"OPTUM","plan_name":"Medicare|All Plans","standard_charge_percentage":27,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":1960.44,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":1923.8,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":1868.83,"methodology":"case rate"}]}]},{"description":"MAJOR HEAD AND NECK PROCEDURES WITH CC","code_information":[{"code":"141","type":"MS-DRG"}],"standard_charges":[{"minimum":13052.16,"maximum":58915.97,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":27917.11,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":25329,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":32062,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":50599,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":29097,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27191.99,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":27191.99,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":25379.19,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":27191.99,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":17403,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":25567,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":25567,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":26983,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":24472.79,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":58915.97,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":39700,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":39700,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":13052.16,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27191.99,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":14912,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":28908,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":21468,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":32116,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":32116,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":27191.99,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18490.55,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18127.99,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":18671.83,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":18127.99,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":18127.99,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":18309.27,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":19396.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":18127.99,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":18127.99,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":17538.84,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":21753.59,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":19396.95,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":19034.39,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":18490.55,"methodology":"case rate"}]}]},{"description":"ASTHMA","code_information":[{"code":"1411","type":"APR-DRG"}],"standard_charges":[{"minimum":1817,"maximum":6722.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":1907.85,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2089.55,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":5014.92,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1817,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":4360.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1817,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":1853.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1853.34,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6722.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1853.34,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":4451.65,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":6722.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":1871.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":1871.51,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":4487.99,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":1871.51,"methodology":"case rate"}]}]},{"description":"ASTHMA","code_information":[{"code":"1412","type":"APR-DRG"}],"standard_charges":[{"minimum":2656,"maximum":9827.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":2788.8,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3054.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":7330.56,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2656,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":6374.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2656,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":2709.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2709.12,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":9827.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2709.12,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":6507.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":9827.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":2735.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":2735.68,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":6560.32,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":2735.68,"methodology":"case rate"}]}]},{"description":"ASTHMA","code_information":[{"code":"1413","type":"APR-DRG"}],"standard_charges":[{"minimum":3365,"maximum":12450.5,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3533.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3869.75,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":9287.4,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3365,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":8076,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3365,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3432.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3432.3,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12450.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3432.3,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":8244.25,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":12450.5,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3465.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3465.95,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":8311.55,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3465.95,"methodology":"case rate"}]}]},{"description":"ASTHMA","code_information":[{"code":"1414","type":"APR-DRG"}],"standard_charges":[{"minimum":6863,"maximum":25393.1,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":7206.15,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7892.45,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":18941.88,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6863,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":16471.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6863,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":7000.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7000.26,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":25393.1,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7000.26,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":16814.35,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":25393.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7068.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":7068.89,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":16951.61,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":7068.89,"methodology":"case rate"}]}]},{"description":"MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"142","type":"MS-DRG"}],"standard_charges":[{"minimum":9831.48,"maximum":44378.2,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":21028.44,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":19306,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":23465,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":37032,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":21295,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20482.25,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":20482.25,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":19116.77,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":20482.25,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":12736,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":18712,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":18712,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":19748,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":18434.03,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":44378.2,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":29055,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":29055,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":9831.48,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20482.25,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":11121,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":21157,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":15711,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":23504,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":23504,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Commercial|Exchange","standard_charge_dollar":20482.25,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"AETNA","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13927.93,"methodology":"case rate"},{"payer_name":"AETNA","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13654.83,"methodology":"case rate"},{"payer_name":"Amerivantage","plan_name":"Medicare|All Plans","standard_charge_dollar":14064.48,"methodology":"case rate"},{"payer_name":"BCBS","plan_name":"Medicare|All Plans","standard_charge_dollar":13654.83,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|HMO","standard_charge_dollar":13654.83,"methodology":"case rate"},{"payer_name":"CIGNA HEALTHSPRING","plan_name":"Medicare|PPO","standard_charge_dollar":13791.38,"methodology":"case rate"},{"payer_name":"DEVOTED","plan_name":"Medicare|All Plans","standard_charge_dollar":14610.67,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Other Plans","standard_charge_dollar":13654.83,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|TRANSPLANT","standard_charge_dollar":13654.83,"methodology":"case rate"},{"payer_name":"KELSEY","plan_name":"Medicare|All Plans","standard_charge_dollar":13211.05,"methodology":"case rate"},{"payer_name":"KINDRED","plan_name":"Medicare|All Plans","standard_charge_dollar":16385.8,"methodology":"case rate"},{"payer_name":"SCANHealth","plan_name":"Medicare|All Plans","standard_charge_dollar":14610.67,"methodology":"case rate"},{"payer_name":"SELECTCARE","plan_name":"Medicare|All Plans","standard_charge_dollar":14337.58,"methodology":"case rate"},{"payer_name":"UHC-SecureHorizons","plan_name":"Medicare|All Plans","standard_charge_dollar":13927.93,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1421","type":"APR-DRG"}],"standard_charges":[{"minimum":3207,"maximum":11865.9,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":3367.35,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3688.05,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":8851.32,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3207,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":7696.8,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3207,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":3271.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3271.14,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11865.9,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3271.14,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":7857.15,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":11865.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":3303.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":3303.21,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":7921.29,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":3303.21,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1422","type":"APR-DRG"}],"standard_charges":[{"minimum":5070,"maximum":18759,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5323.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5830.5,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":13993.2,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5070,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12168,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5070,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5171.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5171.4,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18759,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5171.4,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12421.5,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":18759,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5222.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5222.1,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12522.9,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5222.1,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1423","type":"APR-DRG"}],"standard_charges":[{"minimum":5148,"maximum":19047.6,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":5405.4,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5920.2,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":14208.48,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5148,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":12355.2,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5148,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":5250.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5250.96,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19047.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5250.96,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":12612.6,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":19047.6,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":5302.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":5302.44,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":12715.56,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":5302.44,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1424","type":"APR-DRG"}],"standard_charges":[{"minimum":6466,"maximum":23924.2,"setting":"inpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS","plan_name":"Medicaid|All Plans","standard_charge_dollar":6789.3,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":7435.9,"methodology":"case rate"},{"payer_name":"CHC","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|HMO","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"CHC","plan_name":"Medicaid|STAR","standard_charge_dollar":17846.16,"methodology":"case rate"},{"payer_name":"TCHPCHIP","plan_name":"Medicaid|HMO","standard_charge_percentage":45,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"TCHP","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6466,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STAR","standard_charge_dollar":15518.4,"methodology":"case rate"},{"payer_name":"TCHP","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6466,"methodology":"case rate"},{"payer_name":"TEXASTRUECHOICE","plan_name":"Medicaid|CHIP","standard_charge_percentage":55,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"UHC","plan_name":"Medicaid|CHIP","standard_charge_dollar":6595.32,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6595.32,"methodology":"case rate"},{"payer_name":"UHC","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23924.2,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6595.32,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STAR","standard_charge_dollar":15841.7,"methodology":"case rate"},{"payer_name":"UNITED","plan_name":"Medicaid|STARPLUS","standard_charge_dollar":23924.2,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|All Other Plans","standard_charge_dollar":6659.98,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|CHIP","standard_charge_dollar":6659.98,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STAR","standard_charge_dollar":15971.02,"methodology":"case rate"},{"payer_name":"Wellpoint","plan_name":"Medicaid|STARKIDS","standard_charge_dollar":6659.98,"methodology":"case rate"}]}]},{"description":"OTHER EAR NOSE MOUTH AND THROAT O.R. PROCEDURES WITH MCC","code_information":[{"code":"143","type":"MS-DRG"}],"standard_charges":[{"minimum":19500.23,"maximum":88021.83,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|Exchange","standard_charge_dollar":41708.81,"methodology":"case rate"},{"payer_name":"Bright Health","plan_name":"Commercial|All Plans","standard_charge_dollar":35993,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|HMO","standard_charge_dollar":49274,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":77763,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Surefit","standard_charge_dollar":44718,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Community Health Choice","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40625.46,"methodology":"case rate"},{"payer_name":"Community Health Choice","plan_name":"Commercial|Exchange","standard_charge_dollar":40625.46,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|PPO","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Employer Direct","plan_name":"Commercial|PPO","standard_charge_dollar":37917.1,"methodology":"case rate"},{"payer_name":"First Health","plan_name":"Commercial|All Plans","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Harris Health","plan_name":"Commercial|ERS","standard_charge_dollar":40625.46,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|AP3","standard_charge_dollar":26745,"methodology":"case rate"},{"payer_name":"Healthsmart","plan_name":"Commercial|PPO","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Humana","plan_name":"Commercial|HMO","standard_charge_dollar":39293,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|PPO","standard_charge_dollar":39293,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Commercial|Transplant","standard_charge_percentage":65,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Independent Med System","plan_name":"Commercial|All Plans","standard_charge_dollar":41469,"methodology":"case rate"},{"payer_name":"Interlink","plan_name":"Commercial|Transplant","standard_charge_percentage":70,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"KelseyCare","plan_name":"Commercial|Exchange","standard_charge_dollar":36562.92,"methodology":"case rate"},{"payer_name":"MHealth Network","plan_name":"Commercial|PPO","standard_charge_percentage":100,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"MultiPlan","plan_name":"Commercial|All Plans","standard_charge_percentage":75,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"NX Health","plan_name":"Commercial|PPO","standard_charge_dollar":88021.83,"methodology":"case rate"},{"payer_name":"PHCS Savility","plan_name":"Commercial|PPO","standard_charge_dollar":61013,"methodology":"case rate"},{"payer_name":"PHCS","plan_name":"Commercial|PPO","standard_charge_dollar":61013,"methodology":"case rate"},{"payer_name":"Renaissance","plan_name":"Commercial|All Plans","standard_charge_dollar":19500.23,"methodology":"case rate"},{"payer_name":"Shell","plan_name":"Commercial|All Plans","standard_charge_percentage":50,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Superior Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40625.46,"methodology":"case rate"},{"payer_name":"TCH","plan_name":"Commercial|Transplant","standard_charge_dollar":23938,"methodology":"case rate"},{"payer_name":"USA Health Network","plan_name":"Commercial|All Plans","standard_charge_percentage":85,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|Charter","standard_charge_dollar":44427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Exchange","standard_charge_dollar":32993,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|HMO","standard_charge_dollar":49357,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|PPO","standard_charge_dollar":49357,"methodology":"case rate"},{"payer_name":"W